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My backstory:
A car accident and a bleed in my basal ganglia has resulted in my having RLS for about 15 years with symptoms now being experienced during the day. For 10 of those years, I was on 1.5 mg Mirapex at bedtime and 1.5 mg PRN. At the point where I needed 3 mg per day to sleep (often for as little as 3 hours/night), and having all my credit cards maxed out, I learned about augmentation and impulse control disorders. After a 5 weeks withdrawal period with a doctor who did not believe in the use of opioids, I fired him. I found an MD who was not sadistic and who prescribed 2 mg tapentadol ER BID. It’s a wonderful drug and I finally have my life back. Tapentadol has little CNS effects, and the generic brand is very affordable if obtained outside of the US.
I have been prescribed just about every drug that is indicated for RLS and PD, but I wanted to try the Neupro. The 2mg patch worn continuously was effective for about a week before augmentation began again. I wasn’t surprise that I would need higher and higher dosages, since with a continuous patch, my body doesn’t need to produce its own dopamine. So I researched the drug and learned that it reaches peak plasma levels after about 6 hours and has a 7 hour half-life. Relying on common sense instead of what is recommended by the manufacturer, I went through another withdrawal period, and after my body was able to make its own dopamine, I applied the patch in the late afternoon and removed it upon going to sleep. Since each patch has 30 mg of the drug, I wore each patch for 3 days. Sometimes due to spasms, I awoke earlier than would have otherwise, but it was effective . . . for about a month before augmentation started again. At this point, I started wearing 2 patches and rotated them when they were no longer effective. After needing to wear 3 patches, I was confident they were not the answer to my RLS/PD, so I went back to using Tapentadol. It is my best friend.
Unfortunately, I have an unopened box of 2mg Neopro that I will probably have to throw away. There should be a website where people can donate expensive prescription medications.