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Can Pregabalin Be Taken For RLS?

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Posted on Mon, 9 Nov 2015
Question: I wrote to you on 10-13-15 regarding a change in medications.
I was on Lexapro 10, Cymbalta 30, both daily. I have inherent RLS, and the anti-depressants were making it worse. I had been taking Requip 1mg late afternoon, but had to increase the dose as RLS got worse. I understand there was augmentation of RLS at higher doses of Requip.
Went to see my GP: stopped Lexapro, still on Cymbalta 30 daily. Added Gabapentin 300 TID, supposed to stop Requip. Gabapentin did nothing for RLS. Only benefit is that I feel less anxious and irritable.
I had to keep taking Requip as the RLS was horrible. Am limiting it to 1mg in the evening before bedtime. It helps calm RLS so that I can sleep. However, I still have RLS during the day, but am trying to just put up with it.
I have been on Gabapentin 300mg TID for 1 week now. I know it takes time to take effect, but I haven't seen any response to RLS. My question - might Lyrica
be a better choice for RLS? If not, please advise of an alternate medication.

I need something to calm the RLS (also have Periodic Limb Movement, PLM).
It feels like a Parkinsonian movement, can't stay still, legs moving all the time, very uncomfortable and distracting from my work.

I also need a mood stabilizer, as I am irritable frequently with angry outbursts.
Cymbalta doesn't address this.

Please advise. Thank you.
doctor
Answered by Dr. Seikhoo Bishnoi (2 hours later)
Brief Answer:
Pregabalin can help but if it fails then other drugs can be tried.

Detailed Answer:
Hello thanks for asking again from HCM

I can understand your problem. You have started taking Gabapentin and still symptoms are persisting. In most cases the drug start showing effects in a week though with time progressive improvement is seen. You were taking Ropinirol and the dose increased due to augmentation. If Gabapentin is not resulting in improvement then we should think of some alliterative.

Pregabalin is related to Gabapentin only. But in some studies the drug is found to be very effective in controlling the RLS and some clinicians consider it as reserved drug for poor responders. The drug also doesn't cause much sedation so is better tolerated. You can consider this drug for your symptoms.

Other drug if Pregabalin doesn't result in improvement, that can be considered is Pramipaxol. Pramipaxol is a drug similar to Ropinirol but various studies proved that the efficacy and tolerability of both drugs varies. These drugs might have different response in different people. So you can consider this drug as alternative.

Even if not much improvement occur even then we have more options. Some anti-convulscents can also be used for RLS.

No need to take mood stabiliser at this time. Control of your RLS symptoms and also anxiety will reduce the mood variations. Cymbalta will help in depressive symptoms effectively. Irritation and anger outburst will respond to Pregabalin also. The drug will keep anxiety away and the symptoms will decrease.

Thanks, hope this helps you. Please don't hesitate to ask again for more doubts.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (28 minutes later)
Thank you for these suggestions. I am seeing my GP on Thursday and will discuss
Pregabalin, that sounds promising. Thank you for the other recommendations regarding no need for mood stabilizer, as the right drug to calm RLS will also help with anxiety and irritability.
What is the starting dose of Pregabalin and how often?

Thank you,
XXXX
doctor
Answered by Dr. Seikhoo Bishnoi (34 minutes later)
Brief Answer:
Pregabalin is used in 75 mg dose 2-3 times a day.

Detailed Answer:
Hello again and thanks for asking a follow up

In normal cases Pregabalin is started with 75 mg doses in evening which can be increased to 2-3 times a day. Doses even up to 300 mg are even safe. Please discuss with your doctor for this drug.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (2 hours later)
Thank you, I like to have this information and know the recommended dosing of Pregabalin. Will discuss with my doctor on Thursday.
XXXX
doctor
Answered by Dr. Seikhoo Bishnoi (6 hours later)
Brief Answer:
Thanks and Take care.

Detailed Answer:
Thanks and Take care
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5193 Questions

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Can Pregabalin Be Taken For RLS?

Brief Answer: Pregabalin can help but if it fails then other drugs can be tried. Detailed Answer: Hello thanks for asking again from HCM I can understand your problem. You have started taking Gabapentin and still symptoms are persisting. In most cases the drug start showing effects in a week though with time progressive improvement is seen. You were taking Ropinirol and the dose increased due to augmentation. If Gabapentin is not resulting in improvement then we should think of some alliterative. Pregabalin is related to Gabapentin only. But in some studies the drug is found to be very effective in controlling the RLS and some clinicians consider it as reserved drug for poor responders. The drug also doesn't cause much sedation so is better tolerated. You can consider this drug for your symptoms. Other drug if Pregabalin doesn't result in improvement, that can be considered is Pramipaxol. Pramipaxol is a drug similar to Ropinirol but various studies proved that the efficacy and tolerability of both drugs varies. These drugs might have different response in different people. So you can consider this drug as alternative. Even if not much improvement occur even then we have more options. Some anti-convulscents can also be used for RLS. No need to take mood stabiliser at this time. Control of your RLS symptoms and also anxiety will reduce the mood variations. Cymbalta will help in depressive symptoms effectively. Irritation and anger outburst will respond to Pregabalin also. The drug will keep anxiety away and the symptoms will decrease. Thanks, hope this helps you. Please don't hesitate to ask again for more doubts. Take care