Patient letters on RLS symptoms and remedies- Page 60

 

Kicking RLS/PLMD Patient


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Sent: Saturday, June 25, 2005 5:50 PM
Subject: We found a treatment for RLS.
 
In the course of treating Fibromyalgia we found something interesting you may can use. I host a free web site about a new medical treatment method for FMS.  Many with FMS also have RLS.  This effective method for FMS uses some generic prescription meds and some tricks and tips to make it all work.  It's the combination that does it.
 
Some people want to try just the tricks and tips first.  It won't beat all Fibro symptoms doing it that way, but gives a great deal of relief, is virtually free, and is a good place to start.  From my own experience, and feedback from the hundreds and hundreds on our FMS treatment we found a common benefit.  

Those with FMS who used an eye mask and ear plugs to block out all light and all sound found that their RLS stopped.  Before bedtime they go to the bathroom, chew a few TUMS to lower body acidity, drink a little water and put on the eye mask and ear plugs.  Almost to the person they report that they drop to deep, restorative sleep in about 3 minutes and stay there all night.  If they wake in the night, they just repeat the process, then go right back to sleep.

 
It seems those who have RLS would want to try the same trick and see what happens.  Hope you will share our web site information - the site is free and public domain.
 
Any help I can provide is also free by email or phone.  Thanks for listening.  I hope this helps all of you.
 
In HIS grip,
 
Anne Hillebrand
Orlando, FL
 
Fibromyalgia's Medical Maverick
 
annehillebrand@bellsouth.net
 
407-925-4139
 
www.FibroFix.com

Sent: Saturday, June 25, 2005 6:45 PM
Subject: RLS and muscle fasciculation

I have been reading your website and found it helpful (as I was starting to think that I was either going mad or being very sick). I would like to ask a question and see if this is common. About a year ago I started having twitches in many different muscles of my body, which stated after I had something that looked like a flu type infection.

The neurologist said I have benign fasciculations. But a few months ago I started having a felling of buzzing, or energy inside my legs and sometimes when stronger also in my arms and even in the whole body. The doctor said it could be RLS and that I could try drinking tonic water (because the quinine can help), but this doesn't seem effective.

Another thing is that my husband actually has also been having twitching..  but the neurologist said this is probably a coincidence. We are both only 30 and have had no other problems previously, and this has started about the same time for both of us. Is it common for RLS to develop after or with twitching/fasciculations? should I insist to check that it isn't something else?

I'm worried, I'm only 30 and the doctor was surprised because of my age.  

A.G.

Medical Reply

RLS has nothing to do with fasciculations which are twitches of only one muscle.  RLS does not cause any twitches at all but is associated with PLMS which are gross leg movements at the big toe, ankle, knee and hip.
 
Quinine does not help RLS or muscle twitches but does help prevent leg muscle cramps (which is a different problem entirely).

Sent: Sunday, June 26, 2005 11:36 AM
Subject: RLS could be parasites

I read this message board in it's entirety and am completely amazed that the idea of possible parasitic activity as the causative factor for RLS has never been suggested. I began having twitching in my legs 12 years ago, followed by the "crawling" sensation in my muscles described by many of the patients, as well as heavy 'thumping" type twitching.

After 3 years and 36 "specialists" I was diagnosed with 3 types of parasites. They have actually encysted and calcified in the tissue. The constellation of symptoms for parasitic disease is mind boggling yet most "traditional" doctors don't understand the significance of how epidemic they are, nor how damaging they can be.

I lived in Arizona at the time and parasites are endemic there. The delusion that parasitic disease is limited to third world countries, or only where sanitation is compromised is medieval.   

Linda E.,
Atlanta

Medical Reply

There are no other known reports of parasites and RLS.  It is certainly possible that there is a connection but that remains to be proven.  Just the fact that you have parasites does not prove that they are the cause of your RLS.

Sent: Sunday, June 26, 2005 7:12 PM
Subject: Medications for RLS

I would like to know if it is advisable to take one (1) 0.25 Mirapex at 2:00 p.m. and one  .25 mg Requip at 10:00 p.m. Is it safe to mix two different medications? I'm beginning to have moderate rebound with the Mirapex alone.

Bernice P.,
Beverly Hills, FL

Medical Reply

There is no reason that the 2 drugs cannot be mixed together but unless you have a special reason to take two different drugs there is no reason to add Requip to Mirapex as they both work on the same dopamine receptors.  It is much simpler to just take an extra dose of Mirapex at 10 pm to prevent rebound from taking your dose of Mirapex to early.
 
Also, .5 mg of Requip is needed to equal .25 of Mirapex.

Sent: Sunday, June 26, 2005 9:51 PM
Subject: RLS


My husband (53) has RLS and was taking levodopa for over a year. It worked fine for a while. Incidentally, he also takes small dosages of antidepressants (Desipramine 25mg and Effexor 75mg) & also Klonopin 25 mg for anxiety). Additionally, he also takes kestrel 20 mg for high blood pressure. I know this is a lot of stuff, but all vital for him to function well as there is a family history and genetics that clearing define the need.

Now for the problem. About 3 months ago, the levodopa for his RLS started to become ineffective. He added a natural supplement to boost the level without increasing his prescription. During this time, approximately a week or two, he started to get severe nerve pain in his shoulders and arms weakening his arm muscles. He suspected the levodopa as the cause because when he stopped or started the levodopa, the nerve pain would also stop or start. He stopped the levodopa completely and his doctor prescribed Mirapex as an alternative.

Since both of these drugs act in similar ways, he's concerned he will still have the same problems. He is currently on .25 of Mirapex and although he sometimes sleeps well, once again he experiencing nerve damage to his arms losing strength. He believes that if he continues taking the RLS meds, he will create progressive nerve damage to his body.

I have done so much research and haven't found any side effect of nerve damage or weakening of arm muscles or severe pain in shoulder muscles as a result of taking any RLS meds. I am not sure what drug or drug interaction could be causing this.

I am at my wits end trying to find a solution or some kind of answer of what is causing this side effect and what to do about getting his life back on tract. Right now his choices seem to be stay on Mirapex get some sleep and accept nerve damage to arms and shoulders with fear of it worsening - or - stop the drug and not sleep. Not much of a choice.

Is it possible that taking too little a dosage of Mirapex .25mg or taking too much levodopa could actually cause a deterioration of his muscles?? I was thinking that perhaps the right titration or correct dosage of Mirapex was the problem. (meaning that he is on too low a dosage) My husbands tends to want to stay on small dosages of everything because he has to take so many meds to begin with. Is it also possible that the other meds or combination thereof is causing his muscle deterioration and or RLS??

Unfortunately he doesn't inspire a lot of confidence in having to take meds of any kind and I wish alternative medicine could be an option for him, but don't believe so. He believes in natural heeling, etc. and takes vitamins and other minerals. But, he has also eliminated all of these supplements intermittently, in search of answers to his problem. It's hard for me to get him to confide in his doctor as he finds them a bit complacent.

I do not know of anyone else in his position of having to make a choice between sleeping with nerve damage or not sleeping. Without some kind of help with his RLS, his nights are a nightmare, getting the creepy crawlies and slapping his legs all night. I also understand that RLS is progressive without any meds for treatment and have witnessed that over the last 6 years of this disorder.

Can anyone please give me some solutions or answers to these questions or some kind of insight as to what we can do. I'm sorry this message has become so long, but I wanted to be thorough so that all causes and effects would be clear and nothing overlooked.

I am aware of the new drug Requip, but not sure that changing meds is necessarily the answer, but am open to it.

Thank you for any help,
Janet

Medical Reply

You are correct in that there is no connection with the RLS medications that you have mentioned and muscle or nerve damage. If he is getting nerve or muscle problems then another cause should be investigated.

Levodopa does worsen RLS as it causes augmentation which can dramatically increase RLS symptoms intensity and frequency. Mirapex should work well for RLS but he may need higher doses as .25 mg is still a rather low dose. Although Requip is the only FDA approved RLS drug it is quite similar to Mirapex so unless he does not tolerate Mirapex there is no reason to change to Requip at this point.

The two antidepressant medications that he is taking (Desipramine and Effexor) both tend to cause worsening of RLS and may be part of his problem. If it is reasonable he may do better on Wellbutrin (this drug often helps RLS in addition to treating depression).


Sent: Monday, June 27, 2005 5:24 PM
Subject: Marinol & RLS/PLMD

I'm at my wits end.  I have had RLS my entire life (+30 years).  I have been prescribed different medications including Mirapex, Requip, Neurontin, Gabitril, Xanax, Klonopin, Darvocet, and Vicodin.  While I get some mild results with some, I have yet to get total relief.   It gets so bad that I wake up numerous times at night and have to get up and pace,  play video games, browse the Internet until I'm ready to try to go back to bed.  Other times, I just constantly flip/flop around on my bed.  I typically can't even get to sleep unless I constantly jiggle my feet.  I can't think of the last time I got even 6 hours of uninterrupted sleep.  I have tried hot showers, yoga, and exercise prior to bedtime as well, yet I'm still not getting relief.

At a recent dinner, the topic of my RLS came up and the problems I have been having.  An individual at the table said that she had the same problem, however, her doctor prescribed Marinol and that she has not had a problem since.  She is able to sleep straight thru the night and wakes up refreshed AND NO side effects.  She suggested that I discuss with my doctor.

After looking over your site, I see other mentions of Marinol that might back up what she is stating.  However, I'm afraid to bring this topic up with my doctor due to the stigma of the medication.  I also haven't seen any updated information on your site regarding Marinol and RLS/PLMD or whether any studies have been done to confirm it.

Can you provide any comments on this and/or how best to approach my doctor with this question?  I'm afraid my doctor will think that I'm just looking for a legal way to get high.  With all the other medications I've taken, I would think that Marinol would be safer than some of these and/or other opoids.  Plus if it works....I could finally get some decent nights sleep!

thanks for providing such a wonderful site!

Eric

Medical Reply

I have used Marinol on several of my RLS patients with mixed results.  Most find that it is of little benefit, a few find it is modestly helpful and only one or two found it very helpful.  This of course is very unscientific but probably represents the state of the art knowledge that may exist on this topic today.
 
As Marinol does not cause a "high" sensation there should be no real problem with your doctor prescribing this drug.
 
Here is the information on Marinol which can be found in the Marijuana section of our RLS Treatment Page.
 
Currently there is a drug called Marinol (Dronabinol) that is FDA approved for the treatment of anorexia associated with weight loss in patients with AIDS and nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional anti-nausea treatments.  This drug contains delta-9-tetrahydrocannabinol (delta-9-THC) which is the active ingredient of marijuana.

The effect of taking oral Marinol capsules is quite different from smoking marijuana. After oral administration, Marinol has an onset of action of approximately 0.5 to 1 hours and peak effect at 2 to 4 hours with a duration of action for psychoactive effects of 4 to 6 hours   and does not cause the so called "high feeling".  Marijuana, when smoked will onset within seconds to a few minutes with very high peak blood levels compared to the lower steady levels that onset slowly with Marinol.

Patients find that Marinol does not work as dramatically as smoking marijuana.  Based on anecdotal clinical patient reports it appears that a minority of RLS sufferers may experience a modest benefit for their RLS symptoms with Marinol.  This drug comes in 2.5, 5 and 10 mg tablets that can be taken up to 2-3 times per day with a maximum daily dose of 20 mg.
 

You may want to consider methadone for treatment of your refractory RLS symptoms.


Sent: Monday, June 27, 2005 11:30 PM
Subject: Muscle twitching all over body

I am trying to find out reasons and remedies for muscle twitches which keep me awake at night. They can happen anywhere in the body (arms and legs mainly).  It is more like involuntary muscle jerks that happen just as you are relaxing to go to sleep.  A leg can twitch, an arm can twitch, even muscles in my neck and head can twitch. 

I am currently taking amitriptyline on a regular basis for anxiety and as this has not stopped the muscle twitches I am coming off this to see how I am.  I also suffer from fibromyalgia and have associated low DHEA levels.  The only thing I have found that stops the twitching is clonazepam.  But I have to almost force my doctor to give me this (addiction issues etc). I have been to a naturopath and he has suggested that it is a nerve problem.

A psychiatrist I had to see also said it was a nerve malfunction.  I take magnesium and calcium and this has made no difference.  I am not sure what to think as I never know when it is going to happen and most nights get bad sleep.  I feel that alcohol definitely makes the problem worse.  I do suspect that my nervous system has a big part to play in this problem.

Anyway, I am trying to find solutions to problems that I may not be able to get answers for in the short term.

Susan

Medical Reply

You may just have sleep onset hypnic jerks which do not respond very well to treatment although benzodiazepines like clonazepam may be helpful.  They may also be PLM's which respond poorly to clonazepam but much better to low dose dopamine agonists such as Requip or Mirapex.  You would need a sleep study to differentiate the two possible conditions causing your jerks.
Sent: Friday, July 01, 2005 8:08 PM
Subject: Mirapex and loss of hearing
 
I've been on Mirapex for a couple of years for mild RLS, which has helped. 4 months ago I developed a sudden loss of hearing in one ear; in the space of 10 minutes after some tinnitus started, I had almost no hearing in one ear.

here is a name for this sudden loss of hearing but I don't remember it. The ENT specialists have no idea why this happens but its not uncommon.  Could this be related to the Mirapex?

I've also heard that Mirapex is related to various compulsive disorders. Anything to this?

Neal U.

Medical Reply

There are no known reports of tinnitus or hearing loss associated with Mirapex.  There have been a few lawsuits about compulsive gambling and reports of other compulsive behavior associated with Mirapex and other dopamine drugs when used in higher doses for Parkinson's disease. 
 
So far (to the best of my knowledge) there have been no cases of this compulsive behavior problem in RLS patients.  Whether or not this is due to the lower doses used in RLS or differences in the brain chemistry between Parkinson's disease and RLS patients is not known.

Sent: Sunday, July 03, 2005 2:43 PM
Subject: Any special bed?
 
Hi there from Pennsylvania.  My husband is a restless leg sufferer and uses Mirapex.  Guess I'd rank him in the middle when you read about other people and their battles.
 
He'll sleep through the "twitches" and "thrashes," but, unfortunately, because I've got balance issues, we're searching for a way to still share a bed w/o going to twins.  We've checked out the Posture-Pedic (foam) vs. going to a king (we use a queen now) vs. 2 twins vs. a more stable bed frame (wood vs. the typical metal one).  When it's at it's worst, we'll split up for the night.
 
Any specific suggestions, based on all the questions you're asked, if there is any combination frame, mattress, etc. that will not shake the other person awake?  I did notice one response you gave (use a king or twin).
 
Greatly appreciate any advice.  I would miss snuggling my husband.
 
Sincerely,
Mary W.
Pennsylvania

Medical Reply

The twin beds is still the best suggestion.  Just move them apart by an inch or two and no thrashing will affect the bed partner.  Another, but far second choice, is to get a king size bed (the bigger the better) with memory foam (one brand is called Tempur-Pedic).  The memory foam dampens vibrations very well such that the bed partner should not feel much shaking. You would also have to make sure that there is plenty of material of the cover between you so the shaking does not transmit though the cover.

Sent: Sunday, July 03, 2005 10:30 PM
Subject: Cabaser (Dostinex in the USA) not working well for PLMD?

I have been diagnosed with PLMS, mostly occurring at night. For the past 3 years I have been taking 1mg of Cabaser before bed and have had restorative sleep, until the last month or so.

I am now having difficulty falling asleep, staying asleep, restlessness, and limb movements. I am also noticing period of restless during the day, in my toes, calves and fingers. Is it possible that I have developed a tolerance to Cabaser?

Carol

Medical Reply

No, that is not what tolerance is about.  Tolerance occurs when you become resistant to the therapeutic effects of the drug but the symptoms cannot be worse than before treatment.  You may be getting augmentation which does occur with dopamine agonists but less likely with long acting ones such as cabergoline (Cabaser).
 
It is not uncommon for patients with PLMD when treated with dopamine agents develop problems with RLS.  This may be the first appearance of these symptoms or a worsening of mildly previous symptoms.
 
Your problem may get better with an increase in the dose of cabergoline.  If not, then a change to another class of RLS medication may be beneficial.

A Reply from Carol

Sent: Sunday, July 03, 2005 11:54 PM
Subject: RE: Cabaser

I currently take 1 mg Cabaser before bed, (I was originally prescribed 2 mg and when I was symptom free was advised to lower the dosage  and see if the lower does still worked, which it has done up until recently.

I have recently revisited the web site and note that there is now a warning about Cabaser. Should we (my doctor and I ) be considering other medication? 

Kind regards,
Carol

Medical Reply

The warning is valid but this complication of valvular fibrosis (scaring) occurs very uncommonly.  It can be followed by having a yearly echocardiogram if you are concerned about this possible issue.  Mirapex and Requip are not ergot derived dopamine agonists and do not have this side effect.
 
As the side effect is so very uncommon, you should discuss these issues with your doctor.  Increasing the Cabaser to 1.25 or 1.5 mg should likely resolve your problem.  Switching to Mirapex or Requip are also very reasonable options to discuss with your doctor.

Sent: Monday, July 04, 2005 1:06 AM
Subject: Mirapex not working?
 
I have been taking Mirapex successfully for several years, but in the last few months it has given me very little relief.  I am now taking 1 1/2 -2 mg. a day and it seems to do nothing for me. I am almost back to where I was before being diagnosed, getting very little sleep, which has me utterly exhausted. 

I would like to try Requip, but I'm not sure what dosage I should start with.  My symptoms were typically in the early evening until recently but now they begin by 11:00 am.  Could you advise me what I should do to switch and the dosage so I could request this of my doctor. 

 
Thank you,
Janis

Medical Reply

First, I would like to know the exact doses you take and at what times you take them.
 
It sounds like you have augmentation with Mirapex.  There are several ways to approach this problem.  One is to increase the dose of Mirapex further and take a dose about 9-10 am to treat symptoms which are now starting at 11 am. 
 
The other alternative, as you have already mentioned is changing to Requip.  There is a 50% chance that you may get the same augmentation with Requip but only trial and error will tell us for sure.  The dose of Requip is generally twice the dose of Mirapex (for example, substitute 1mg of Requip for .5 mg of Mirapex).
 
Another alternative would be to change to another type of medication (my choice is narcotics and methadone is my favorite) for a few weeks.  Often going back to Mirapex or Requip at that point (after the dopamine receptors have had a chance to reset) will bring things back to the way they were when you initially started the drug.

A Reply from Janis

 
Sent: Monday, July 04, 2005 1:43 PM
Subject: Re: Mirapex not helping?
 
Before this became I a problem I was taking 3-4 of the .25 mg around 4:30 pm as I generally had that creepy crawly feeling around 7:30 pm when I wanted to sit down and watch TV or read.  That usually carried me through the night (even though I still woke up for no apparent reason around 3:00am). 

Now, I am still taking the .25 mg, but I will take one by noon and again around 3:00 pm, another between 6:00 - 8:00 pm, again around 10:00 pm, just when I want to get into bed and sleep and I still wake up many times with my legs bothering me. If I get desperate enough I take a couple more pills.  Last night I was wild they were so bad, so I think I took even more than 2 mg total yesterday (then I woke up this morning with a drug headache hangover).   All of these times are because my legs are bothering me and it doesn't seem to matter if I take 1, 2, 3, or 4 pills at a time.  I get almost no relief!

As for the methadone, I would certainly be willing to try it, but is this something that most doctors are willing to give their patients?  I have a very good doctor when it comes to listening  to what I have to say about my treatment because he knows I know what I am talking  about, but he is becoming more conservative with prescribing so I'm not sure if he will be open to it.

Thank you for your suggestions and I really think the latter is the way I should go as it really seems like the Mirapex has almost stopped working, period.

 
Janis

Medical Reply

I think that part of the problem is the way in which you are taking your Mirapex.  Once symptoms are present it is much more difficult to get rid of them and often even much higher doses of Mirapex will not help much.  It is far better to prevent symptoms by taking a larger dose 1-2 hours before the onset of any symptoms.
 
I would suggest taking .5 to 1 mg (try the lowest dose and work up every 2-3 days if necessary) at 9-10 am then another dose if necessary at about 3-4 pm then a third dose 1-2 hours before bed.  I think that this regimen would have a better chance at controlling your RLS symptoms.
 
If this is not helpful, then the methadone route should work well.

Sent: Tuesday, July 05, 2005 2:53 PM
Subject: RLS & Mirapex augmentation?

I am a 48 year old male with RLS. This was diagnosed via a sleep study. At first, approximately 1 year ago, the RLS was VERY mild. In fact, I considered not even taking medication. However, a  neurologist at Duke University suggested I take Mirapex to aid in sleep, and  advised the drug was "very safe".

I do feel it is safe, however I am experiencing what I consider "severe augmentation". I now have RLS at all times of the day, including occasional bouts in the am, which previously NEVER occurred. The Mirapex does help me get to sleep, but the daytime symptoms are horrible!

I basically have 2 questions.  Would a switch to Requip be advisable?  If I stop Mirapex, does the augmentation subside and return to only evening bouts? I have never heard this issue addressed.

Thank you so much for your time in responding to all of us sufferers. It really is a debilitating condition, and your input is GREATLY appreciated!

Robbie J.,
NC

Medical Reply
 

Usually the augmentation symptoms return to normal when the dopamine class drug is withdrawn.  This may take several days to weeks.  A switch to another dopamine agonist is often be successful (in your case a switch from Mirapex to Requip) but only trial and error can decide this issue in any given individual.
 
Some patients may notice that the intensity of the RLS symptoms subside after withdrawal of the dopamine drug but the earlier onset and extension of symptoms to other limbs may not improve as much.

Sent: Saturday, July 09, 2005 5:07 PM
Subject: Weaning off Mirapex?

I have been on .75 mg. of Mirapex for 4 years and recently have experienced augmentation and those sensations in the arms during the day.   I take one 300 mg. Neurontin at bedtime.   Recently I have added one Neurontin around 2:00 p.m. and have noticed a decline in daytime augmentation.

I would like to get off Mirapex and need advice on how to gradually reduce this medication.   Also, if I can go completely off  Mirapex, should I increase Neurontin and/or add another drug, perhaps an opioid?

I am a senior and have had  RLS all my life, actively for the past 20 years.   I am healthy and live an active lifestyle, but would like more sleep.   I get about 4 to 5 hours sleep a night without RLS but experience insomnia and sleep attacks during the day.  I understand that Mirapex can be the cause of this.

Penny

Medical Reply

You should reduce the Mirapex slowly so as not to cause an increase in your RLS symptoms.  Decreasing by .125 mg each week should work well.  You may find that once your dose is lower (perhaps .5 mg or less) that the augmentation may disappear.
 
You will likely need an increase in the Neurontin at bedtime as you decrease the Mirapex, but you may want to try only decreasing the Mirapex first and see what happens.  Opioids would be fine but as you seem to be doing well with Neurontin it might be wise to stick with that drug.
 
The daytime sleepiness may be from the Mirapex but it may also be from the Neurontin.  Check to make sure that the daytime sleepiness problem did not begin with the start of your daytime Neurontin dose.  Mirapex can also cause insomnia (most of the patients who get insomnia do not get daytime sleepiness with the drug) which may decrease as you decrease the dose.

Sent: Saturday, July 09, 2005 10:47 PM
Subject: Changing from Permax to Requip?

I have severe restless legs both day and night that began 11 years ago, shortly after having my thyroid removed.  For the past five years I have used Permax fairly successfully, but it no longer seems to work.  I was taking one .05 mg  in the morning, and another .05 mg Permax about four in the afternoon since my restless legs become quite active early in the evening.  Until four  months ago I was also taking two .25 mg  Permax before bed and getting about 6 hours sleep before RLS awakened me. 

All of a sudden it stopped working.  My doctor eventually increased the evening dose of Permax to four .25 mg  pills, but I got only two or three hours of sleep on that dosage.  In the past I have tried Klonopin, Sinemet, Mirapex, and Neurontin, so we decided to try Requip.   I have spent many totally sleepless nights the last 10 nights, and have worked myself up to a dosage of 2.5 mg of Requip, but I am still not getting any relief.  I don't sleep at night, and my legs are going crazy in the daytime as well. 

I have used a little Xanax and/or Ambien to help me sleep while I add sufficient dosage of Requip for my needs, but it's like taking candy.  They do nothing to help. At this point, my neurologist feels her RLS experience is too limited to help me and she referred me to another doctor who can see me in three months.  I'm desperate. 

Any suggestions? Thank you!
Jan

Medical Reply

Your problem is actually quite common and has a simple solution.  You are likely having augmentation from dopamine drugs and should probably stop using them.  The drug of choice at this time would be a narcotic.  My choice would be methadone, at 5-10 mg 2-3 times per day.  That should easily control your RLS symptoms.  Once controlled, you could add Neurontin and Ambien to see if you can lower the dose of methadone.
 
In the future, you might also be able to add low doses of Mirapex or Requip and they too might help lower the narcotic dose.  However, if you notice any worsening of RLS with low doses of these dopamine agonists then they should be stopped.

Sent: Sunday, July 10, 2005 1:02 PM
Subject: Possible urinary side effects from Mirapex?

I am 49 years old. I have had RLS since age 21. Until about five years ago I thought I was the only person with this affliction, which my wife termed “crazy legs”. I went to a sleep clinic and was prescribed Mirapex. It has been wonderful. I take two pills (0.5mg?) every night and the problem is gone. As an added bonus, I feel that Mirapex improves my concentration. I now draw a parallel between my childhood and teen attention deficit disorder (way before this was understood or treated) and eventual RLS.

The problem is this: I have had a problem peeing (suspected prostate) for almost as long as I have been on Mirapex, and it has lately become worse. One side effect of Mirapex is I believe a slight lowering of blood pressure. The drugs prescribed for the “peeing” problem are essentially blood pressure lowering drugs (alpha blockers). I cannot seem to handle the two pills at the same time. I seem to be faced with a difficult choice of discomforts. 

I recently found a reference to possible side affects of Mirapex as including troubling urinating. Perhaps the long term use of Mirapex is actually a cause or contributor to my peeing problem????  I'm wondering if any readers are aware of a link between Mirapex and urination. I'm also wondering if there are anyone is aware of any naturally occurring substances that operate in the same manner as dopamine agonists? 

Many thanks.
Sheldon R.

Medical Reply

It is possible that Mirapex is causing some prostate problems and slowing down your urine flow.  This is not one of the common side effects but certainly does happen.  Also, it may have an additive effect with your alpha blockers (prostate pills) causing some further lowering of blood  pressure.
 
Alternatives would include changing to Proscar, a prostate medication that shrinks the prostate over several months (works totally differently from the alpha blockers) and may solve that problem.  Also, you may try to lower you dose of Mirapex slowly (by .125 mg per week) and see if a lower dose is still effective for your RLS and then causes less urinary side effects.

A Reply from Sheldon R.

Sent: Monday, July 11, 2005 10:54 AM
Subject: RE: Possible side effects from Mirapex
 
I really appreciate your help. One follow up question, instead of using Mirapex, does Requip offer a chance of avoiding my urinary side effects?

Thanks again,
Sheldon R.

Medical Reply

Although Requip is a dopamine agonist that acts quite similarly to Mirapex, the side effect profiles tend to be somewhat different and there is a reasonable chance that urinary problems due to Mirapex may not be caused by Requip (and vice versa).





















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The information and advice on RLS given on this web site is for educational purposes only. None of the advice, information or medical treatments should be followed without the supervision of your medical provider. The information presented on this site is not a substitute for your doctor, but should be used to help you discuss your RLS problem with your doctor. Do not undertake RLS medication treatment on your own! Please seek qualified professional medical care to help treat your RLS symptoms.


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