RLS, Pramipexol and loss of inhibition with spending and sex

Hi @cms239 - welcome to Mayo Clinic Connect.

I thought your post was significant enough to warrant its own discussion and in the Sleep Health support group where others regularly discuss restless legs syndrome (RLS). So here is where it now is located:

- RLS, Pramipexol and loss of inhibition https://connect.mayoclinic.org/discussion/rls-pramipexol-and-loss-of-inhibition/

In your personal experience, how did you connect the feelings and actions of inhibition in yourself to the medication you were taking for RLS? I'm guessing you reported this to your sleep specialist/neurologist? If so, what did he or she say about this connection?

I had RLS and Functional Movement Disorder. I was prescribed Gabapentin 300mg three times a day. It has greatly helped the FMD and totally stopped the RLS. I know what works for one person doesn't always work for another, but it might be worth discussing with your doctor.

My husband was on Ropinirole (dopamine agonist similar to Pramipexole) for 13.5 yrs for Periodic Limb Movement Disorder. Later the RLS started. We now know that dopamine agonist can cause augmentation which makes RLS worse. It was discovered he was gambling and was "swinging". When it was all discovered our primary care made a huge error and told him to go cold turkey. He now has what we believe is Dopamine Agonist Withdrawal Syndrome. He was doing fine on Bupropion aka Wellbutrin after he became almost suicidal. He insisted on going off and what our primary care didn't think of was that Bupropion actually helps with dopamine. He first lowered it and my husband became apathetic but I didn't put two and two together. After a month he stopped taking it and my husband crashed. He went into Anhedonia and emotional blunting. We had worked through the impulse control disorders and had gotten very close. Within 5 days of being off the medication my husband decided he never loved me and went into a severe depression. He was put on 300 mg of Bupropion and is slowly improving but after 7 weeks he still is not himself. His brain has to learn how to produce it's own dopamine because the dopamine agonist flooded it for years. After stopping the Ropinirole the impulse control disorders stopped. So did the RLS! He is now on gabapentin and baclofen for the PLMD. Please if you stop the Pramipexole do not go cold turkey. You must slowly wean. Tell your physician about the gambling and sexual urges.

In England, they recently banned (legally banned, I understand) use of dopamine agonist drugs because of the problem you describe (impulsivity)---It is a serious side effect just coming to light. I hope because you recognize the cause that you can make good decisions--override impulsiveness tendencies--and find another treatment that works for the RLS. I take buprenorphine and use Nidra bans on my legs at night. Knock on wood--I have had no RLS symptoms, at all, for the last week. Dopamine agonist drugs are problematic. They work GREAT, but only for a while. Then, they are "not good" for more than one reason. Thank you for sharing your experience. Please keep the forum updated on how you are doing. Best of luck to you.

@lisalucier https://www.bbc.com/news/articles/cgkmrev6z2mo