Pramipexole is a dopamine agonist---this type of medication (I understand) works well until it doesn't and leads to augmentation (worsening of symptoms and the medication not working at all). I'm curious how long you have been taking this drug, rjjb? My doctors says dopamine agonists ALWAYS leads to augmentation---but I wonder if that is true across the board. I would appreciate hearing your experience. I recently got a Nidra device from Noctrix company which helps a lot when my symptoms are mild to moderate. Noctrix is a California based Company and the device was paid for by Medicare. When my symptoms are really bad, nothing works. I've been taking buprenorphine for about a year and 9 months. It's been helpful. Each night is very different and most of the time I can't see "cause and effect" from what I have done during the day. I quit sugar for a several months a few years ago, but that made no difference for me. RLS is a weird malady and from reading posting it seems our experiences can be quite different. Gabapentin and Iron IV didn't help me at all. It's heartwarming to read that some treatment is successful. This is not an easy row to hoe. Having a knowledgeable doctor is key, I think. Best to you!