requip

[maybe]

I have been on pramapexole 1mg Had to stop went on gabapentin but RLS told me I should go to requip but being on 1mg of pramapexole how much requip can I start with 1/4 mg to start would not be enough They said I should, go to a Doctor who deals with RLS all I got out here, who is a GP who is a good doctor but not up on RLS. I could use some advice, thank you

maybe

[Polar Bear]

I am wondering......what was the reason you stopped the pramipexole. If you had to stop the pramipexole, why does doc think that ropinerole will work, they are both DAs.
It is true that some people can do better on one than the other. I am just interested in the reasoning.

Regarding your dosage of ropinerole, you were on Gabapentin since you stopped the pramipexole. i.e. you are not changing straight from pramipexole to ropinerole.
It is essential that you start on a DA (i.e. ropinerole) on the lowest possible dose and titrate upwards as necessary, and keep it as low as possible. Also the mg dosages pramipexole/ropinerole do not equate and you wouldn't be taking the same dosages.

[maybe]

I had 3 surgeries since than pramipexole did not seem to be enough. I did want something to stop my stress but he first put me on simenet after 3 days I stopped and went to gabapentin 300mg. which is not enough during the day. I am going back to the doctor.. RLS solutions said I should go on requip.as bad as my RLS is how can I start requip at a low dose. I know they start you off at 1/4 mg. PLease tell me the right way to go I keep getting different answer. I am going to the doctor Friday what do I tell him. How do I handle a low dose as bad as my RLS is. Would like help. thank you


maybe

[Polar Bear]

You mention daytime symptoms so I am assuming that you have WED/RLS for much of the 24/7.
You were on pramipexole but this didn't work after you had 3 surgeries.
You were on Simemet for 3 days - Glad you came off this, it should not be used on a regular daily basis because of its high % rate of augmentation.
You tried Gabapentin 300mg which has not worked - I understand that a dose of 300mg is the starting dose and that you would expect to titrate upwards until you hopefully reach the level that controls your symptoms.
It has been suggested to you that you should try Ropinerole but you are fearful that the starting dose of .25mg will not be sufficient.

I don't know how long you have been on the Gabapentin 300mg but it looks to me like this medication hasn't actually been given a proper chance to see if it will help. I do understand is difficult to deal with uncontrolled symptoms when changing medications and while working up to a dose that will give relief. It is also possible that when you came off the pramipexole, you would have had withdrawal symptoms to deal with, on top of your WED/RLS symptoms. And the Gabapentin may not be sufficient to deal with the extra burden of the withdrawals. i.e. once the withdrawal period would be over (perhaps 3 - 4 weeks) the Gabapentin may be sufficient once it was increased to a level that controlled your 'normal' WED/RLS.

Another option could be a cocktail. This is where more than one medication is used and it is how I control my own symptoms which are 24/7.
I use ropinerole at 9am, 1pm, 5pm, 10pm and 3am.... in varying doses.
I also take tramadol 50mg at 1pm, 100mg tramadol at 5pm. And at 10pm I take 50mg tramadol and 30mg cocodamol.
This is just a suggestion as to how a drug medication cocktail can work and how it works for me.
I am not saying that this is what you should do. I am just providing some information from my own experience.

You ask for the right way to go, and that you keep getting different answers.
People give different suggestions because they speak from what they personally know. This disease affects us all in different ways and the medications for treatment work different for all of us. Unfortunately this sometimes means a case of trial and error until we arrive at what works for us as an individual.

Also have you had your ferritin serum level checked. This is a blood test that is not done as routine blood work. It checks the stored iron levels and these levels are not reflected in a normal blood check. 'Normal' levels can be around 20 or 30 but for us sufferers they should be up around 100, especially if using a drug such as pramipexole or ropinerole. Many doctors don't know this. Ask to have this test done and when getting the results, ask what the actual level is, don't just accept that it is 'normal.'

http://www.mayoclinicproceedings.org/ar ... 4/fulltext
This link will provide good information from The Mayo Clinic. You could print this out and highlight where you believe is relevant and take it with you to your doctor for discussion. Use highlights because he won't have time to go through it all. But for your own information.... reading it will provide you with information so you can talk and discuss with your doctor from an informed position.

Sorry this has been such a long response but I hope there will be something you can take from it to your appointment.

Good luck with your appointment.

[Polar Bear]

Maybe -.....-- do you have anyone who can go with you to your GP appointment. Go in with you to see Dr and perhaps reinforce to Dr how you are suffering. Also to help remember exactly what Dr says and to discuss the benefits or otherwise of different methods of treatment.