Augmentation, Low BP, and chronic heart failure

Use this forum to discuss any issues associated with Augmentation
Post Reply
Belsheart
Posts: 11
Joined: Thu May 10, 2018 2:29 am

Augmentation, Low BP, and chronic heart failure

Post by Belsheart »

A couple of years ago I managed to reduce my pramipexole to .125, butt it was a hellish experience and ultimately doctor Trotti of EMORY sleep center advised staying on that small amount. Fast forward to today and I have augmentation worse than ever. So I'm going to have to get off it. I've since moved and no longer have access to a sleep excellence center. I have very low blood pressure and chronic heart failure, so I know I won't be allowed opioids. Any suggestions?
I just need moral support

badnights
Moderator
Posts: 5925
Joined: Tue Mar 10, 2009 4:20 pm
Location: Northwest Territories, Canada

u

Post by badnights »

Belsheart wrote:
Mon Mar 15, 2021 2:50 pm
A couple of years ago I managed to reduce my pramipexole to .125, butt it was a hellish experience and ultimately doctor Trotti of EMORY sleep center advised staying on that small amount. Fast forward to today and I have augmentation worse than ever. So I'm going to have to get off it. I've since moved and no longer have access to a sleep excellence center. I have very low blood pressure and chronic heart failure, so I know I won't be allowed opioids. Any suggestions?
I just need moral support
Hi Belsheart
I moved your post to a topic of its own, so people will notice it more. It sounds like you really need to be treated by a doctor with a lot of experience in WED/RLS. How far are you from another Quality Care Center? I haven't heard from any other people in your situation, which is a hellish one to be in.

How is your iron status? Have you had tests of your serum iron, transferrin saturation, TIBC, and ferritin recently? What was your ferritin last time you had it checked? If you're not taking iron, perhaps you should be. If you could arrange it, and if your bloodwork supported it, an iron infusion a month ahead of stopping pramipexole might make your life way easier.

It is possible to control WED/RLS with anti-convulsants, although they usually aren't effective on their own for people who have augmented. There are a number of other oddball medications that might be useful - the only one I can recall right now will not be useful (it's mainly used to reduce BP) but there are others. I can look if you remind me...

The big danger of opioids for you, as I understand it (and I'm not a medical professional) is suppression of heart rate and lowering of BP, clearly things you don't want. But there might be more to investigate there, since I came across a study in which the authors were testing how effective oxycodone and morphine would be at relieving breathlessness in stable Congestive Heart Failure patients. (They didn't help, but the paper discusses why they might have.) And a review article on the same topic. So some doctors see a use for opioids in people with CHF. There might be something for you and your doctor to investigate there - perhaps a very low dose of an opioid, combined with an anti-convulsant, would allow you to get some sleep, which has to help stabilize your health in other ways.
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

ViewsAskew
Moderator
Posts: 16308
Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: Augmentation, Low BP, and chronic heart failure

Post by ViewsAskew »

Pramipexole is known to lower BP, if I remember correctly. I wonder if coming off of it would actually help that?

What other things have you tried?
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Post Reply