Restless Legs and Neurontin

So in my last post I mentioned that I have started taking Neurontin to treat my restless legs rather than using Tramadol. That post was last Wednesday, today is Tuesday, so what has happened in between, I hear you asking.

On Wednesday night I took Neurontin again, but took 900mg.  I fell asleep pretty quickly but unfortunately woke up after 2 hours with intense restless legs.  It was terrible.  Anyone who has been woken up with bad restless legs will know exactly what I’m talking about.  You are really tired and just want to sleep, but can’t due to your damn legs.  In this situation I usually overreact in an attempt to get quick resolution, and indeed did overreact, by taking 100mg of tramadol when 50mg probably would have done the job.  The tramadol still took 45 minutes to kick in.  45 minutes of hell!

So Thursday I don’t start feeling any Tramadol withdrawal symptoms until around 2.50pm.  So that means approx 16 hours since my last dose.  I take another 50mg tab and within an hour the withdrawal symptoms are gone.  That night (Thursday) I took 1,200 mg at 8pm in order to avoid the nightmare of the previous evening, and am happy to report that I slept through without needing any Tramadol again!  I am a little groggy in the morning but am still able to function ok.

At 8.15am I start getting sweaty and fidgety.  It isn’t too bad yet but I have a meeting at 10am and rather than risk functioning poorly at the meeting, I pop a Tramadol 50mg.  Within an hour the fidgeting and sweats have gone.  8pm at night to 8.15am means 12 hours since my last dose (as opposed to 16 hours the day before).  I think the literature says that 12-16 hours is typical for Tramadol withdrawal.

Friday I went out with some friends and had quite a few drinks.  I know that alcohol (especially wine – which I avoid) sets off RLS, but I still took 1,200mg of Neurontin and no Tramadol just to see how it would cope.  It did pretty well until 3am when I woke with mild restless legs, so I took 50mg of Tramadol.  I remember seeing my clock again at 3.30am and then nothing, so I guess it worked!

I started getting some Tramadol withdrawals late afternoon on Saturday (which coincided with my last dose at 3am), so I took another Tramadol.  That night I took 1,200mg Neurontin and slept through the night.

So that has pretty much been the pattern.

Since the doctor didn’t give me very much Neurontin, I had to go back yesterday (Monday) for a refill.  I saw a different doctor (who I think was better) and I explained my need for more Neurontin as well as my history with RLS.  I also explained that I was pretty sure I was suffering a dependence on Tramadol and was weaning myself off, trying to stick to one 50mg tab per day, and whether 25mg tabs existed.  The doctor said that in his opinion Neurontin was a much better drug to be taking for RLS than Tramadol if the Neurontin was working.  I agreed with him explaining that I hated talking to doctors about how I took Tramadol to control RLS as they always looked at me with the “here’s another addict” look afterwards.  He nodded in agreement!  He said that 25mg tabs of Tramadol don’t exist and that I shouldn’t open the capsule to remove some powder (I suggested this as a method to cut down) as I may not remove the active ingredient.  Instead he prescribed me some low dose xanax (0.25 mg) and said that every 4th day or so I should try and get through the day by taking xanax for the withdrawal symptoms rather than Tramadol, with the long term plan being to get me free of xanax.

To be honest I felt great after seeing him.  It seemed like he was knowledgeable, caring and genuinely interested in seeing me get better.  Didn’t seem to judge me at all for being dependent on Tramadol, and didn’t have a punishment complex like I’ve seen on some (usually older) doctors.

He also gave me a refill of Neurontin, this time giving me 600mg tablets rather than the 300mg capsules I had previously.  Last night I took 1,200mg of Neurontin at 8pm, and didn’t feel sleepy or any effect. At about 9.30pm my legs were restless and I tried a 0.25mg  xanax.  I was still awake at 10pm, and took a Tramadol as my legs were mildly restless.  I finally went to sleep around midnight.  Not sure why this time Neurontin didn’t make me sleepy.  I’m wondering if it was the Neurontin (perhaps bioavailability of pills is less than capsules) or something else. Tonight I plan on taking the Neurontin at 7pm to see if timing makes a difference.  I do note that those on the trial took their Neurontin at 5pm.

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