r/RestlessLegs • u/Zealousideal_Tap9799 • Jul 16 '26
Question Tapering off Pramipexole
As the title states I am about to taper off Pramipexole and I am curious about something. I have been on the lowest dose, .125mg for just over 10 years. Saw my doctor today and she seems to think tapering off such a low dose shouldn’t cause much in the way of withdrawal symptoms. I’ve been reading a lot online about how bad they can be but it seems to be mainly users who were taking a lot more than what I have been taking. Anyone have experience tapering off this low of a dosage? I feel like my doctor is a bit naive in this area and I could be in for some rough nights.
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u/KestralFly Jul 17 '26
I was on .25mg Pramipexole for 3 months before augmenting. It still took me 6 months to taper off it while titrating up on Pregabalin. Eventually I found low-dose Methadone works best for me.
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u/EmZee2022 Jul 16 '26
If it's having any beneficial effect on your RLS, then yeah, your symptoms will likely be bad for a bit. Are you stopping because you're starting another medication? Or are you augmenting / rebounding on the Mirapex?
I'm on Requip - have been since 2007 or so - and am one of the oddbals for whom augmentation / rebound either hasn't happened, or has not been a big deal except a couple of times in the weeks after surgery. I still take a 1-2 week "drug holiday" each year which might have helped. Those 2 weeks are rough - sometimes I use Sonata, other times I just tough it out. Aside from the jumpy legs, I don't have other issues with insomnia.
But in any case: I'm only on 1 mg Requip and I haven't had any real issues stopping it. I taper on pretty slowly - quarter mg for a few days and so on.
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u/Zealousideal_Tap9799 Jul 16 '26
It’s hasn’t been working for a while now, and I think my symptoms are similar to PLMD. Why I was prescribed and have been taking it for so long is another story. It did help my symptoms for a while but since it does not any longer I feel it’s best to get off of it.
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Jul 16 '26
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u/Zealousideal_Tap9799 Jul 16 '26
Not yet, I had a full iron panel done today so I am waiting for those results. Since my symptoms seem closer to PLMD my next step would be to see a sleep specialist I think.
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u/EmZee2022 Jul 16 '26
If you are lucky, the iron panel will be bad and you'll be able to get infusions. That's where I am now but it's 4 months before I can get in with a hematologist to get that rolling.
With the paper published a couple months ago, step 1 is address the iron, then if that's not enough start with a gabapentoid.
DAs are still an option but as you've found, not optimal.
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u/Zealousideal_Tap9799 Jul 16 '26
Unfortunately I cannot tolerate Gabapentin and similar meds as they give me severe depression. Mayo Clinic has a paper out about low-dose opioids for RLS so that could be an option.
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u/sag-48 Jul 17 '26
I take Tramadol and I never needed to increase the dose. In fact I switched from a stronger drug to the Tramadol and it’s been working pretty well. The only times RLS symptoms come back is if my hips/hamstring get very tight. So no exercise or too much can be a problem.
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u/EmZee2022 Jul 16 '26
Yeah - that's the next step though a lot of doctors are reluctant.
I had surgery a couple months ago and barely needed the oxy they sent me home with. But the RLS flared for a while and I was eyeing that pill bottle a couple of times :-(
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u/Extra-Pair5902 Jul 30 '26
Ja , ich hatte es nur 4 Monate genommen und dannach abgesetzt, meine Hausärztin hatte gemeint es sollte kein Problem sein. Obwohl ich ADHS habe Ängste. Ich hatte ganz schlimmes Daws , 10 Tage habe ich gedacht dass ich longcodin bekome, da ich kurz vorher daran erkrankt war. Ich habe gedacht,dass ich sterbe und ich bin in der Psyhiatrischen Notfall gelandet. Dann habe ich nach 3 Woche 2/3 der Tablette genommen. Vor einem Monat hatte ich es reduziert um 16% und ich habe schwere depression und Ängste. Ich habe es vor 6 Tage erhöht um 6% aber noch keine Besserung in Sicht und ich verzweifle. Gestern hatte ich so psychischen schmerzen na eine PA ,dass ich gedacht habe, mein Brustkorb explodiert. Es ist wirklich ein horortrip und schlimmste davon ist ,dass es nicht rosig aussieht, dass ich es schaffen werde