Rather Pregabalin with Restless Legs?

If I’m to believe reports about this, it seems that doctors are increasingly opting for pregabalin when prescribing medication for restless legs.

Previously, the choice usually fell on a dopamine agonist such as ropinirole or pramipexole. With these drugs, however, it appears that a large part of the people who take them have to deal with augmentation.

The question here is whether pregabalin is a better choice in all respects. I will take a closer look at this topic in this blog.

What is pregabalin

Pregabalin belongs to the ‘family’ of anticonvulsants. I wrote a blog about other medicines before. Anti-epileptics are mentioned therein as one of the alternatives to dopamine agonists.

In addition to pregabalin (Lyrica), this group of anticonvulsants includes the drug gabapentin (Neurontin). These are both prescribed for epilepsy and nerve pain. Both names have the letter combination ‘gaba’ in them. That’s no coincidence.

GABA is an amino acid that the brain produces on its own. In the human body, this substance acts as a neurotransmitter. GABA has a calming effect, regulates stress and inhibits nerve impulses. It also helps in better muscle relaxation.

Pregabalin is a successor to gabapentin.

It is not only prescribed as a remedy for epilepsy, but also for (peripheral) neuropathy, fibromyalgia and as a remedy for anxiety disorders.

You have to build up this drug. It only works after a few weeks. Pregabalin does not work for everyone, however. You can’t just stop once you’ve started. In that case, tapering off under the guidance of a doctor is best.

Side effects of pregabalin

It is of course not certain that you will get (all) side effects. The most common side effects with pregabalin are drowsiness/drowsiness/fatigue, headache and dizziness.

However, there is still a whole list of side effects that occur less often, but still with some regularity. The side effects should occur during the first period of use and then pass.

Side effects occur with any type of medication. This is not unique to pregabalin. It is questionable how often serious, more permanent side effects occur with this drug, compared to other drugs. Not much is known about the long-term effects.

In the messages I read about this, I see that side effects can be such that it is a reason for someone to stop taking the medication. The remedy is then worse than the disease.

Examples of disruptive side effects include severe difficulty concentrating and forgetfulness, depression and anxiety. Constipation and weight gain are also quite disturbing for many people. Usually this is not bad enough for the person in question to stop if the pregabalin does help well against the complaints.

People on fellow sufferers’ forums regularly write that they only notice how addictive the substance is when they stop. They experience horrible withdrawal symptoms. Some say that if they had known that they would never have started it.

Unfortunately, the guidance of doctors in tapering sometimes leaves a lot to be desired. Moreover, tapering strips that help to reduce gradually more easily are often not reimbursed by the insurance.

Fellow sufferers

From what I read from fellow sufferers, I don’t immediately get the impression that pregabalin is already completely common among neurologists.

Some do not receive a prescription for pregabalin or gabapentin until after a number of years they have started to suffer from augmentation of dopamine agonists.

I also don’t get the impression that many neurologists provide their patients with very detailed information about what exactly they (will) take and what the risks are. There are bound to be many reasons for this. Little time will be one.

The standard for many neurologists still seems to be ropinirole and pramipexole. It may be difficult for the older generation of neurologists to switch to something different from what they are used to. I don’t know to what extent neurologists are regularly trained in these matters.

What also makes this difficult and inconclusive is that neurologists are not obliged to prescribe a particular drug. They can make their own choices about this. So it just depends on who is your doctor.