Follow-up question regarding Requip discontinuance

[rlsidaho]

I recently posted a question about my discontinuance of Requip XL and the increased RLS-WED symptoms. I have been taking hydrocodone (7.5 mg) at 6pm and (10 mg) at 10pm nightly with success prior to my augmentation and Requip subsequent discontinuance.

My question is this: in order to alleviate the majority of my RLS-WED symptoms during discontinuance withdrawal I am needing about 12.5 to 15 mg of hydrocodone every 4 hours. Without this amount I am literally wanting to crawl out of my skin. The "growing pain" feeling and joint pain is quite high as well. Is this dose within what one would consider a "reasonable and normal" range given that I am just entering my 4th day after stopping Requip cold turkey? I recently switched to my GP for treatment and he is overseeing my treatment at this point. He prescribed 7.5 mg every 6 hours as needed and this amount isn't even making a dent in my increased symptoms.

I guess I'm hoping that someone can give me some general guidelines, as I will need to discuss with my GP in the next day or two if my discontinuance withdrawals continue for the usual time period most have referenced. Thank you in advance for any feedback you can provide.

[dogeyed]

The way I see it, you should ask your GP doc to please change the prescription to exactly what you ARE taking to get relief. I should think he would agree, and hopefully longer than just a month or two, rather permanently, or you'll eventually have to face slowly reducing what you're on. The reason why your legs did not handle rebound very well by taking meds at 6pm and 10pm is not only did you not have enough opiate, you also didn't have any of the hydrocodone in your system all day long! So, whatever happens with the doc, take what you got and spread it out thru the day, it'll make things a little easier. By the way, hydrocodone alone SHOULD tame your normal RLS symptoms all by itself, but if not, I agree with your idea of putting Mirapex back in, since it worked so well for so long.

By the way, I have the severe painful nonstop form of RLS, untreated I about went crazy, and in fact read on this forum about someone who did, and I have complete relief from 30mg codeine 4x daily for years. An estimated equivalency is 30mg codeine equals 5mg hydrocodone. So, while everyone is different in what works for them and how much medicine they need, that should give you some idea of what dose CAN control RLS under normal circumstances. Whilst in augmentation, you would need more, as is evidenced by you having to resort to taking so much more than you were prescribed. I hope your doc will cooperate on this issue, just be upfront with what you're doing, so he'll know how to better help you. GG

[Chipmunk]

Maybe something like Lyrica would help for the joint and muscle pain?

[rlsidaho]

Hi Tracy, thanks for the input. I've tried Lyrica without much success.

[rthom]

I have at my disposal both long acting and short acting meds (hydrocodone or hydromorph) so that if it's really bad i can control it and not have to kind of guess what i'll need or overmedicate. It also allows my dr to see how much long acting i really need--more or less. Since the times and symptoms vary so much in a day schedule--why take more during the day when i need it at night, that kind of thing.
Any reason this shouldn't be considered?

[rlsidaho]

I think that has merit, if my doctor agrees.

[rthom]

For sure, i'm going to have to be more careful what i say. I wasn't suggesting you do it that way-just food for thought.I meant that, having merit, comment as a question for others reading in case there's a reason my dr shouldn't be doing it, or another idea for people to consider. Thanks for the reminder.

[rlsidaho]

I understand what you meant.

[rlsidaho]

I hope you didn't take my response the wrong way. What I meant was that it would be refreshing to have my doctor place enough trust in me to allow me to know when to take the appropriate type of med, depending on the symptom. I am on day 7 of discontinuation withdrawal from being on a DA for over 5 years. No fun....

[rthom]

Sure,
First i'd have (as it was pointed out here a while back--thanks for that guys) to say I got lucky with a great dr.
It's important to recognize the lucky/ good components as they can be few or hard to see.
Also I'm personally careful to let the dr know when i'm pleased or thank them for a job well done on something every once in a while--it's important to have a positive report, i find it hard in the limited time to take a moment to acknowledge their achievement--even if not alot, as they wear out too.
The most important thing for me was my responsibility, i'm brutally honest with my dr. There are times that i have to choke out things because i know she's not going to like what i've done or about to say. It's a safety thing if they feel you'll keep both you and them safe it's easier to gain their respect or at least a good working relationship. My dr knows she'll be made aware of everything and when all is said and done i will follow her directions, unless it's unsafe to do so.
Hope this helps somewhat.

[rlsidaho]

It does, thank you for your insights.

[jstep]

Hi,

I don't have any insight or experience to offer because I haven't been down this road yet. I do agree with the others about being upfront with your doctor about what you are experiencing and what you need. I have been reading your posts with a lot of interest . From everything I am reading , I may soon be facing the same situation. I travel to Dallas next Thursday to see a sleep doctor recommended to me by Dr. B. I don't know yet what he will want to try but after everything I have read, getting Mirapex out of my system is a big possibility. I wish you all the success and my thoughts are with you. I am interested to read about your next appointment. Good Luck.

Jamie

[rthom]

How'd u make out with your dr on this?

[rlsidaho]

My doctor had been on-board with me thus far. Great news.

[rlsidaho]

Quick update on my efforts to rid Requip from my body for those that are interested. It's been 3 weeks so far and if I don't have hydrocodone in my system, the RLS is ever present. My prescription lapsed yesterday and the pharmacist was unable to fill it until this morning. Last night was complete Hell. I paced all night long, felt like I wanted to crawl out if my skin, and the pain in my lower legs was extreme.

I met with my doctor on Monday and he said it may take up to 6 weeks to get the Requip out of my system. I was on a DA for almost 6 years. I just secured an appointment with a neurologist at the Mayo Clinic in March. I'm hoping for the best!