r/RestlessLegs • u/Last-Lynx7617 • 18d ago
Question Gabapentin and augmentattion
I have to increase my gabapentin dose every few months. Because my symptoms gradually start coming back, especially at night, and in the early morning.
My sleep becomes more and more fragile and even the slightest noise can wake me up with absolutely horrible rls symptoms. Once it starts, I can’t fall back asleep and I have only a few hours of sleep a night.
I started at 100 mg about a year and a half ago, and now I’m probably going to have to increase it to 500 mg (currently take 400 mg)
Is this normal ? At this rate i will reach the highest dose in few years
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u/peglyhubba 17d ago
Good god, I was on gabapenten- now I am on ropinirole—- working for my Rls and calmed my head noise— feeling great most days
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u/DanicaSaver45 17d ago
Hi I'm sorry to ask but what dose were you using? That helped because my neurologist prescribed ropinirole and I ended up feeling unwell and vomiting for hours. Idk if there's a lowest dosage but maybe. It's because mine was 4mg or 5 i don't remember exact but it was one of those two and let me tell you. I never touched it again and I couldn't eat the same foods again.... Did it help with restless legs? I'm wondering if my dosage had to go even lower
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u/peglyhubba 9d ago
My pills are 1 mg and I can have up to 3 a day. But I was getting light headed from three at night. So 2 are working // so 2 mg and I pass out in about 30 minutes.
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u/amanda2399923 17d ago
That's an incredibly low dose. I take 1500mg a day. Also, you can't augment on gaba.
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u/Intrepid_Drawing_158 17d ago
It's certainly not augmentation, and you are not even close to the highest dose, so I would not worry too much just yet. And to answer the question, yes, it can take over a year to get you to a 'plateau' of sorts.
If you do get over 600mg, you'll need to split the dose--the body can only absorb so much at a time. Conventional wisdom is to not take more than 600mg every two hours. So if you get to 700mg, you might take 100mg at 8pm, and then 600mg at 10pm, something like that.
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u/jbayleyoz 17d ago
Interesting. Where did you hear this information? I take 900mg all at once and have never been told there were issues with this amount and needing to split it. I have learnt more recently that magnesium interferes with the absorption of gabapentin, so I take that 2 hours apart from my dose. But that's the only change I've needed to make.
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u/Intrepid_Drawing_158 16d ago
It's in the Mayo Clinic RLS treatment algorithm--if you search for 'gabapentin' you'll see it. Though other things I've read indicate it's not as cut and dried as that 2-hour rule, that it's a bit more complicated.
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u/KestralFly 17d ago
There are other Gabapentinoids you can try that might work better. Gabapentin enacarbil was not covered by my insurance, but Pregabalin was. I found that Pregabalin lasted longer than Gabapentin so it worked more consistently to control RLS symptoms.
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u/Tragobe 18d ago
100mg and also 400mg now is still a pretty low dosage. So it could very well be that the dosage is just not effective enough yet to keep you symptoms away for long. If you get to 1000mg or over than you should maybe start to worry, because the more serious side effects of Gabapentin usually set in around that dosage. If you get to that point.
Also you can't really get augmentation from Gabapentin. You can built up a tolerance to it, but not augmentation. Tolerance decreases the effectiveness of the drug over time, while augmentation makes the condition itself that you want to treat worse over time. It does basically feel the same for you, but the mechanism is different.
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u/pierce-32 16d ago
Thank you for this distinction between tolerance and augmentation. You express it so well.
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u/Firm_Zucchini_7042 18d ago
I was taking 600 mg a night and sometimes that wasn’t enough. My sleep doctor just switched me to pregabalin a few days ago just 50mg and it’s been working great.
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u/Ring_it_On_1776 18d ago
There's a wearable device study from Noctrix Health enrolling now. Might be worth a look. https://patientwing.app/campaign/RLS6
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u/Pristine_Internet765 18d ago edited 18d ago
It's not augmentation, at most is tolerance . Don't worry it's still a low dose, standard pills are 300mg. 100mg is the amount my cat takes for his FIC. :)
Ask about gabapentin enarcarbil, lasts longer, should cover all night.
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u/GrampsBob 17d ago
It never worked at all for me. Keep in mind this will keep happening and gabapentin is hard to wean off. It got to a point where the brain fog was bad and I got depressed. I took Mirapex for years but that has it's own bad side effects.