Requip Questions

Slinky · Post by **Slinky** » Tue Sep 25, 2007 3:57 pm

Okay. I had some RLS during my sleep evaluation. I don't remember if they also showed up during my titrations. I've been aware of them OCCASIONALLY and given the three sleep evaluations I've had thru the years it appears that some nights I don't have them, some nights I have a few and some night I evidently have them real bad. From my own personal observations of RLS whilst awake I may have them 3-4 nights in a row at most, then go weeks or even months w/o them occurring whilst I'm awake. A maxium of 5 times I've had them actually wake me up to consciousness that they occurred or are occurring. This since 1994 when my sleep problems started after a whiplash.

My sleep doctor has now decided he'd like me to try Requip. .25 mg for a week, then if no problems .5 mg.

I'm undecided if its worth the risk of undesirable side effects. My main concern is digestive upset. I have Crohn's disease currently in at least symptomatic remission and I have virtually NO TOLERANCE for nausea at all. I do MUCH BETTER handling pain than nausea. MUCH BETTER!

At this point I'm disinclined to start the Requip. I don't feel the RLS is bothering me enough to make it worthwhile to add yet another med to my regimen, not even thinking of possible side effects.

I'd be interested in others' experience w/Requip - especially those of you who really weren't aware of having any RLS until your sleep evaluation. Not because you didn't know what it was but because you just weren't aware of any leg jerks, etc.

sleepyred · Post by **sleepyred** » Tue Sep 25, 2007 4:45 pm

My major complaint with Requip was the stomach upset - I changed to Mirapex and have not had the stomach upset with that - Others have no side effects. I also have a low tolerance for medicines.

Slinky · Post by **Slinky** » Tue Sep 25, 2007 4:57 pm

Thanks, SleepyRed. I'll look into Mirapex. I'm just no convinced the RLS is bad enough to consider take ANY RLS med. But I'm trying to NOT close my mind w/o giving it fair consideration.

sharon1965 · Post by **sharon1965** » Tue Sep 25, 2007 4:58 pm

slinky
could you be more clear about whether you are experiencing Restless Leg Syndrome or Periodic Limb Movement Disorder?

i have both, and i take requip...but if it was just for restless leg i wouldn't...i take it because the limb movements occur every 17-30 seconds throughout the night while i sleep and cause full arousals about 1/4 of the time

i haven't experienced any pronounced side effects, although i still feel tired all the time and that could be due to the meds...for now, i'm putting up with that to get my sleep in good order, then i'll try to find another solution

btw, low ferritin (the protein that stores iron) can be a cause of rls and plmd...have you checked into that? i also take prescription iron supps and would rather do just that than both the iron and the requip, if i had a choice

sleepyred · Post by **sleepyred** » Tue Sep 25, 2007 5:01 pm

Yes, by all means have your ferritin checked. Mine has fluctuated between 13-27. My sleep doc said it must be at least 60.

Slinky · Post by **Slinky** » Tue Sep 25, 2007 5:11 pm

Thank you, too, Sharon. I always get PLM and RLS mixed up. My hubby has the slow, rhythmic movements of his feet and legs whilst sleeping. All I've experienced to my knowledge is the tic type of like an electric shot jerk reflex of the legs.

In July we checked: CBC w/diff & plateletts, phosphorus, magnesium, ferritin, iron, vitamin B12, carbohydrate metabolism, T4 free, TSH and homocysteine plasma. Today we did a draw for ferritin and darned if I could read the other 3 tests he scripted. Gads! No wonder there are so many medication mistakes given handwriting like so many of these doctors are guilty of!!!! Everything checked out okay w/in normal limits in July. B12 was very close to the top of the reference range.

sharon1965 · Post by **sharon1965** » Tue Sep 25, 2007 5:23 pm

yes, slinky, your ferritin could have been within normal range, but normal range is between 10 and 250 (it varies very slightly from lab to lab)...mine was 6 (!)...as sleepyred pointed out, the level needs to be at 60 to address rls or plmd, so even if you were at 30 (which is where mine has gradually risen to--so far) it's still not high enough...i'm still on both the requip and the iron supps till we can get it up to 60, then i can try going off the requip

if you are having restless leg sydrome symptoms (AWAKE) that interfere with your quality of life, or keep you from falling asleep, then yes, i guess i would say take the meds...if you have periodic limb movement disorder (ASLEEP), and if it's severe enough to cause arousals, it can seriously interfere with restful sleep and no amount of xpap in the world will completely address excessive daytime sleepiness, even if your xpap therapy is successful in treating your OSA

hope that helps

Slinky · Post by **Slinky** » Tue Sep 25, 2007 5:43 pm

Our lab's reference ranges for ferritin are 10-291 and mine was 125. I know from 30 years of raising and showing dogs NEVER trust a borderline high or low "normal" reading. I also know that NONE of these tests are totally reliable and when symptoms and tests don't jive sometimes its worth relying on good medical instinct and tentatively treating the symptoms.

In reading about Mirapex and Requip they seem to be VERY similar medications. Like a toss-up whether one, the other or both would or wouldn't work. I just am not aware of my RLS symptoms being bad enough to make it worthwhile to try them. Another titration study would just be another tossup whether they were bothering me that night or not.

Gads!! I'm really sounding like I've closed my mind to taking either med!! Not what I intended at all! They both have to be taken 3 x a day according to The Pill Book which totally disenchanted me.

sleepycarol · Post by **sleepycarol** » Tue Sep 25, 2007 5:46 pm

Slinky,

I am in your boat. I didn't realize I had any leg movements until my sleep study and my doctor said he thought I had RLS because of all the leg movements. I don't have the symptoms of RLS while awake and am inclined to think it is PLMD instead. The doctor is wanting me to try the Requip and has qiven me enough for 2 weeks in samples -- like you starting out at a lower dose and then moving up. I have balked at taking any more meds as I am already taking several meds that are necessary due to high blood pressure, asthma, allergies, and GERD.

I am going to give the APAP a chance and if I don't see an improvement in my sleep if a few weeks then I will reasses the situation and might consider the Requip then.

sleepyred · Post by **sleepyred** » Tue Sep 25, 2007 5:48 pm

sharon - how long have you been taking iron? I took it for 2 years until it basically wrecked my stomach. My gastro doc - said no more iron! So my ferritin slowly drops and drops. I augmented to the Mirapex so here is where I am today.

Last week I had a 5 hour iron infusion. I have read extensively on this topic and have found out that some people just can't store iron. My sleep doc and hematologist he sent me to are both hoping that this will kick my system into gear. It has been a week and I've read that my ferrin is probably "peaking" now and will taper within the next two weeks to a baseline. Time will only tell if I can keep a higher level of ferritin.

I am slowly weaning myself off of the Mirapex as my symptoms are slowly improving. I've had a week of "getting used" to the java jolt of iron and it has not been easy, but not bad.

My RLS symptoms were basically shaking the bed so bad with my legs that my husband almost fell out of bed. If I was not shaking the bed, I was kicking the daylights out of him! This stopped with the Mirapex, but was coming back with a vengeance. Now my symptoms are getting better and better!

kteague · Post by **kteague** » Tue Sep 25, 2007 5:56 pm

Slinky,

Those little jerks you describe still could be PLMD. It looks different in different people (though your husband's is a common description). Do your sleep study results give you some idea which your movements are, or maybe both?

Two issues on whether to treat are #1 Are sleep arousals affecting daytime function, and #2 Are day/evening RLS symptoms significantly comprising your well being? The decision on whether to treat or not can become clearer if the test results show whether the movements cause arousals. Even if so, when you have to weigh other health concerns, I don't envy your decision.

While I've never taken Requip, I do take Mirapex and for me it keeps my stomach feeling bad - not nauseous at all, just yuck feeling. Maybe if one's RLS or PLMD is mild but still needing treatment, a small enough dose would work that wouldn't be so hard on the system.

But about those normal blood test results... You could have a ferritin level that reports within the normal range but still not be optimal for persons with movement issues. It needs to be around 60 - not a matter of the typical normal. I'm working on getting mine up there so I can see if the meds can be dropped.

Let us know what you decide to do and the results.

Kathy

sharon1965 · Post by **sharon1965** » Tue Sep 25, 2007 8:06 pm

slinky said:

Our lab's reference ranges for ferritin are 10-291 and mine was 125.

YOWZAH!! that's a nice high ferritin level...guess low iron isn't the culprit for you...however, with stomach/digestion/colon issues, i don't blame you for really weighing this decision

sleepyred said:

sharon - how long have you been taking iron? I took it for 2 years until it basically wrecked my stomach. My gastro doc - said no more iron! So my ferritin slowly drops and drops. I augmented to the Mirapex so here is where I am today.

Last week I had a 5 hour iron infusion. I have read extensively on this topic and have found out that some people just can't store iron. My sleep doc and hematologist he sent me to are both hoping that this will kick my system into gear. It has been a week and I've read that my ferrin is probably "peaking" now and will taper within the next two weeks to a baseline. Time will only tell if I can keep a higher level of ferritin.

sleepyred, i've only been on the iron supps since the spring, and so far no stomach issues...at my last check up in july, my ferritin had risen from 6 to 30, so that's good news...as i mentioned on another thread, the sleep doc says if we can get it up to 60 i can try going off the meds...but what really puzzles me is what's to keep the ferritin from dropping again if i go off the iron supps? the whole thing is a mystery to me

that iron infusion thing sounds intense...i hope it does what it's meant to do for you...you and i have discussed these issues before, so i have some idea of what you're going through...geez, if it was just OSA, i think i'd be well on my way, since i feel i've tolerated cpap quite well...just our luck it has to be more complicated than that, huh?

Slinky · Post by **Slinky** » Tue Sep 25, 2007 8:07 pm

Thanks, Kathy, and everyone. Now I "am" totally confused. I went to see a sleep neuro for a second opinion this summer. Wasn't totally happy since my insurance was charged a whopping initial office call (even for a specialist it was a whopper) but I never saw the sleep neuro, just her NP. She ordered the July bloodwork I mentioned above and scheduled me for a follow up appointment. Everything came back normal and I received a phone call telling me the results were all normal and to continue w/my current sleep doctor. So - I was under the impression that their office was done w/me and I wasn't to return. Yeah, well, the neuro's office left a message on my answering machine to remind me of my appointment tomorrow morning at 9:30 AM!!!!!

Like, does the left hand know what the right hand is doing? In order to be there at 9:30 I have to leave the house at 9 AM at the latest. Their office doesn't open until 9 so its not like I can call and ask if they are sure I am supposed to keep that appointment. I'm TOTALLY undecided whether to keep the appointment or not!! I guess it depends on the mood I'm in when I wake up tomorrow!

I'm heading to bed. Will let you know tomorrow what I ended up doing, keeping the appointment or not. Mumble, grumble. I swear the older I get, the crankier I get!!! Kathy, I'll respond to your post better tomorrow. I'll have to dig out the sleep studies to see which term they used: PLM or RLS.

kteague · Post by **kteague** » Tue Sep 25, 2007 9:28 pm

Slinky - Sorry, didn't see the ferritin result when I posted before, must have been typing at same time. About the meds being 3 x day - I've always been prescribed them just in the evening and/or at bedtime. The 3 x day may be general instructions for Parkinson's use or if RLS torments all the waking hours, which doesn't seem to be your case.
Kathy

AdmiralCougar · Post by **AdmiralCougar** » Tue Sep 25, 2007 9:57 pm

I know this is already probably to late especially if you don't check the boards first thing in the morning, but missing that appointment could cause you and or your insurance to have to pay as much or close to for missing the appointment. I know if I don't cancel an appointment at Kaiser 24 hr. in advance there is $10 fee which is half of what my copay is.

Christy

Requip Questions

Requip Questions

RLS and PLMD

In addendum to prior post

Mask

Additional Comments: Aussie Heated hose for rain out/PapCap Headgear and chin strap