Exercise

[Flying_Jim]

I take 0.75 MG mirapex at bedtime, but I always have to endure about 1 to 2 hours a severe restless leg after taking the mirapex. The mirapex does not last for 24 hours, but I am at the maximum dose. I bought myself an exercise bicycle, which allows me to watch TV while I am waiting for the mirapex to take effect.

I am also walking several miles a day. While I am doing these things I experienced no discomfort, but the restless leg starts up again as soon as I stop.

Eventually, the mirapex kicks in and I can go to sleep. My restless leg is starting earlier and earlier during the day. I am desperate to find a solution, but in the meantime the exercise helps me to endure the restless leg it seems to be inevitable. I would dearly love to drop the mirapex. I've read suggestions on this web site that marijuana may be of help. I am considering whether are not to try this, but I hope that the cure is not worsen the disease. However, I doubt that anything can match the restless leg for the sheer misery it is causing.

[D4]

... My restless leg is starting earlier and earlier during the day.

I'm not a doctor, but it sounds like you could be augmenting on Mirapex. That's when Mirapex/Requip/Sinemet stops helping you and you have RLS symptoms earlier and earlier. The solution is to get off it (you may have to taper down) and get on something else.

If you search for augmentation, you'll find a lot of posts about it. It's probably also in the New to RLS sticky.

I found this board when I was augmenting on Requip (and I didn't know what that was and neither did my doctor!) I just knew I couldn't handle it and was in a desperate search for help. The fine people here knew right away what my problem was and they were right.

[Flying_Jim]

... My restless leg is starting earlier and earlier during the day.

I'm not a doctor, but it sounds like you could be augmenting on Mirapex.

Thank you for that bit of information.

Since I've been unsuccessful in trying to get off the mirapex all Gabapemtin once I will try to reduce the dose with a view to trying something else. Does anyone have some suggestions? I've tried many drugs including Mirapex, Welbrutin, amitriptyline, sinemet, Gabapentin, Levadopa, Clonazepam and Requip. I am not sure I spelled although these correctly, but you get the idea. Some of these actually made the problem worse and I experience augmentation on others. I am currently on a combination of Gabapentin and Mirapex. I think you are correct, but for the moment I have run out of options, unless some of you can suggest something that has not been tried. I have seen no less than five sleep specialists, each one referring me on to the next one after experiencing failure. As outlined in other posts, I am trying to reduce the symptoms through improved blood sugar control, and diet and exercise.

So far, these event no impact other than during exercise. Occasionally doing something that is very mentally absorbing, such as computer work, helps. I am temporarily, I hope, retired while I attempt to bring my restless leg under control. I find it difficult to commute, which makes contract work very difficult, so the reason for doing such computer work does not currently exist.

I find it helpful, believe that are not, to browse the bookstore. While browsing my mind is active and I am on my feet. As a rule, I cannot read, which is something I desperately enjoyed. I've taken to reading while I walk in my neighborhood. It causes some comment, but so what? Since I know the sidewalks in my neighborhood the safety of this is a little bit better than would otherwise be.

Ocassionally I am driven to eating while standing when I am out with my family. I will not pretend that this is completely pleasant, but the alternative is sheer misery given that I made the mistake of going out in the first place. I am sure that people notice, but what is the alternative?

If I can get absorbed enough in a conversation sometimes I can control the restless leg by rubbing it. That works for a while.

This opportunity to discuss my experiences and share knowledge with others, such as yourself, is in itself a tonic that has helped to control my restless leg at least temporarily. Up until this point depression was starting to dominate my mood. I've actually been screaming in frustration.

I cannot say enough about how much I appreciate this bulletin board and the people who are taking time to offer suggestions. Thank you.[/i]

[SquirmingSusan]

Jim, look up the Mayo Clinic Algorithm. It has recommendations for which drugs to try, and when. It sounds like you have tried everything except the opioids - Those are the only meds that have worked for me. Is your doctor willing to prescribe them? If not, you may need to find a new doctor who has the guts to stand up to the DEA, and get you some relief.

Susan

[ViewsAskew]

Ditto what Susan said - the Algorithm and a doctor willing to help. . .check out the sticky posts in the New to RLS and the Pharm section of the board. These will provide great links to things that may help you get educated - often, until we know the best options, we can't ensure the docs work with us to achieve the best treatment.

[Rachel]

Jim,

What would happen if you took your Mirapex in the afternoon. I have to have my Mirapex already cooking in me well before my legs start to twitch. What would the doctor say?

Good luck
Rachel

[Flying_Jim]

Rachel,

Thank you for the suggestion.

I delay aking my Mrapex until bedtime because that is the only way that it wil last the night. Because of nausea, I do not want to increase the dose, but there may be room to play around bit with the timing.

Regards,

Jim

[ViewsAskew]

Jim, you could try splitting the dose and see if it works - some people do that pretty effectively and use the same dose. If you take .75, try taking .25 of it, say, at 6 or 7 PM. Then take the remainder at 9 or 10 PM for a 10:30-11:30 bedtime. The first dose should be still working enough so that you are covered and you don't have to wait for the bedtime dose to work.

With Mirapex and Requip, it's essential that you get it in before the RLS starts on any given night. If not, it works, but not as well and it takes longer.

Also, can you take anything for the nausea? While traditional nausea drugs worsen RLS, a few of them don't. You can also try ginger - both in tea form and to eat the root (candied or fresh). I couldn't have managed my withdrawal from Klonopin without ginger - I was nauseous for months. The ginger really reduced that and helped a lot.

[Flying_Jim]

ViewsAskew,

Thank you.

I will give both of your sggestions a try. I have tried varying timing, but perhaps not systematically enough.

Regards,

Jim

[Polar Bear]

Jim, I take requip 2mg and found the best working method is to take half a tablet at around 7pm and the other half at about 9pm. It helps cut the nausea, helps with the early evening symptoms, and gets going before the twitching starts. I do have the twitches in the afternoon when I am at work but the action of driving home after work seems to settle things for a while, and then I start the meds before it all plays up again.

Its not always perfect, but its the best way that I have found.

Good luck, Betty

[Flying_Jim]

ViewsAskew and Betty,

I tried taking a pill (out of 3) just as my RLS statred up around 4 pm. It worked for the most part and did not seem to affect my ability to sleep when I took the other two.

I was able to enjoy an evening out with my wife and the only symptom was a bit of tiredness - that beats the alternative.

Thank you both. I will keep you informed.

Regards,

Jim

[Polar Bear]

Glad something helped. Yes, I would also get a little bit of tiredness, but I'm happy to put up with it, if other things 'fall into place' a bit better.

Good luck. Betty

[Rachel]

Jim,

So glad for you!

Rachel

[Flying_Jim]

I have been trying this for several days now and it still seems to help. I do not know why it did not work before. The value of another set of minds at work is illustrated once again.

Thank you all for the suggestion.

Jim

[ray]

TTT