DAWS post Mirapex

[jaybird8]

After being on Mirapex for 7 years and dealing with augmentation, I tapered down and got off the medication in July with the help of Dr. Early at Johns Hopkins. I started Gabapentin shortly after getting off Mirapex. The Gabapentin seems to be managing my RLS rather well so far. Since getting off Mirapex I have been battling depression. Recently it has been fairly severe...usually only 2 to 3 days a week though. I have suffered from very mild depression before, but this is different. It is much more constant and the really bad days are much more severe. I was hoping that after 5 months I would be in a better spot with the depression but it actually seems worse.

I recently have been trying to read up on DAWS (Dopamine Agonist Withdrawal Syndrome.) I seem to fit with how others have described DAWS. I was wondering if any of you have experience with DAWS and could share your experiences. I have great hope in the self healing abilities of the brain, but am hoping to hear from others and how long the depression may have lasted and what you may have done to cope. Thanks

[badnights]

I'm sorry I can't be of help in terms of personal experience with DAWS. I hope someone here has experience to share with you. I do know it does go away, but it can be extremely difficult to wait it out. One 2013 study found that recovery took less than 6 months in 61% of DAWS patients. The ones with the hardest time - longest period to recovery - had impulse control disorders as part of their DAWS spectrum, so if you're coping with depression but no ICD, you might expect a faster recovery, assuming the correlation was meaningful that way.

I encourage you to chronicle your journey here, even if no one else can share similar experiences; it's amazing what talking about it can achieve in terms of coping ability, and you've got a very sympathetic, encouraging, and knowledgeable audience. Be brave, and come back to us often.

[sleepdancer2]

I found it hard to distinguish depression from the lethargy of sleep deprivation. I was one who still struggled with limb movements disrupting sleep as well as sleep apnea, and I was on meds that had this side effect. I also had the impulse disorders side effect. I would say it was a few months after getting my sleep to a decent point for me to feel markedly better. Until my sleep apnea was treated, my meds changed, and my legs calmed, I still felt like a zombie. Had a lot of recovery to do. Good luck sorting through your particulars. I guess the point of my post was two-fold. Address all contributors. And there is hope.

[ViewsAskew]

In the ten years I've been here, I only recall DAWS coming up a handful of times. Most of us are on low enough doses that it doesn't happen to us. But some of us do get to high doses.

How much were you taking? And, how did you taper the reduction?

I actually wonder if it's the gabapentin that is the cause. Depression is a common side effet - including suicidal ideation.

[jaybird8]

I was on 0.75mg of Mirapex at the highest point. I am now on 1500mg of Gabapentin. I have wondered about the Gabapentin being connected to my depression, but have put those thoughts aside for two reasons. First, Dr Early did not seem to think it was the cause. He put the chances of it causing the depression at less than 10%. Second, the Gabapentin has been effective in managing the RLS so I really don't want to think about eliminating that as an option. Maybe the time has come to at least tape off and see what impact that has on the depression. My concern there is the impact of loss sleep to the depression. It is such a tangled web of issues to try to filter through. Arghhhh!!!!!!!

[badnights]

Ann is so right. Sorry I didn't twig to this. I should have, as you'll see in my other post.

[ViewsAskew]

I am not a doctor - I can only go by what I see here. In years, we have only had a handful of DAWS cases - an all at high amounts. .75 mg doesn't qualify.

We have had a LOT of depression and some of it related to gabapentin, but most of it? It just is. We already have brain chemistry that isn't working optimally. Then we add drugs that change it and are tired and don't sleep. I am surprised we're not ALL depressed.

It's terribly hard to tease apart as you noted.

[veldon75]

True! I stay depressed with or without the Gabapentin because of the RLS but I do feel worse when I take Gabapentin. I just recently started back on it and I noticed Im more tired and feel hopeless.

[jaybird8]

Checking back in. Since cessation of Mirapex in July I have been dealing with bouts of depression...significant at times. By late August my GP put me on Welbutrin (300mg). That helped a bit, just kind of evening things out a bit, but I still have constant depression symptom I never had before the Mirapex withdrawal. Went to see a pychiatrist yesterday for the first time who now wants to add Abilify (2.5mg to start progressing to 5mg after 10 days if needed)

Being that it is a partial dopamine agonsit, I have concerns about this course of treatment. Not sure if it has similar properties as Mirapex or not. Doctor does not seem to think it will be an issue. Though it is a partial dopamine agonist he does not feel that when I come off of Abilify that it will create similar experience as coming off of Mirapex or post Mirapex. Given the difficulty of getting of Mirapex and the subsequent depression after the fact, I am just concerned about any type of dopamine agonist of any variety.

Does anyone have any experience with Ability to treat depression? Doctor was very confident that the depression is temporary, though no idea how long to expect to go through DAWS, and that I will be able to cut our Welbutrin and Ability at some point. I would love to hear from any of you who may have gone this route before me.

[Sojourner]

No experience with Abilify but just want to post and hope that the meds will work for you and that the depressive mood will indeed be transitory. Best of luck.

Wishing all who visit here some peace this night.

[ViewsAskew]

Abilify - aripiprazole - is usually characterized as an anti-psychotic (a neuroleptic, in this case), and this is one of the few anti-psychotics that may not be harmful for us. No systematic study exists, that I know of, that shows if it hurts or helps.

Could be that the psych wants to try it because there isn't anything negative out there about it and there is with many of the traditional anti-depressants.

Tough call - having had both RLS and depression, I'd likely try it if the depression was on-going. Just in case it hurts, it's one or two nights. But, if it helps? It's like a new life.

[jaybird8]

Well, I checked in with Dr Early before purchasing and using the Abilify. He was not supportive of it, but provided a list of what he would consider acceptable. Can't say I was upset after finding out from my pharmacy that Abilify was going to cost close to $500 (have not yet met my deductible for the year). That is just outrageous.