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tapering dopamine agonist drugs


Penstemon

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this may not be the place for this question but I can't find any other resources to help me.

 

My brother-in-law was prescribed Mirapex (pramipexole) for restless leg syndrome and is now having very severe SE's and needs to come off of it. I can't find any info on how to taper it. there is a really bad w/d syndrome associated with abrupt cessation-much like with any other psych drug. It even has a name (DAWS- dopamine agonist withdrawal syndrome). If I can't find any specifics, I guess I will suggest the general tapering rules for other psych drugs.

 

BTY-any of you taking this or other dopamine agonist drugs(requip) for RLS, Parkinson's and other off label uses (fibromyalgia,depression,social anxiety disorder) should educate yourselves. these are very dangerous drugs .

 

Thanks for any advice or resources. wishing you all well!   

10/10- lithium(300mg)-began taper ~2/12 at 10% per 10 days to 2 wks
12/10- emsam(12mg patch)-began taper 12/12 over 4 months
1/11- lamictal(150mg)-began taper 12/12 tapered rapidly over one month
2006-seroquel(250mg max dose)-began taper 10/11 at 10% per 10 days to 2wks until current dose of 50mg.
10/12-viibryd-began taper 4/27/13 and ended in 47 days
1989- temazepam 30mg began taper 12/12

3/10 Ativan .5-2mg prn began microtaper 7/11 from 1.5mg

3/13 trazadone(100mg) added for sleep

26 yrs polypharm. ECT

Seroquel 50mg  Ativan1.66mg  trazadone 72mg  crossed temaz to Ativan 3/14. held 2 mos
 

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Same principles as tapering any other neuroactive drug.

 

See http://www.drugs.com/pro/mirapex.html

 

It comes in a range of dosages, in tablets that are scored for splitting. One could get prescriptions filled with the lower dosages and cut them up for tapering gradually over at least 3-6 months.

 

Magnesium is often quite effective for "restless legs" -- another vastly overdiagnosed condition.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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thanks Alto for the quick response.he's using the smallest dosage pills so looks like he will have to titrate to do small enough cuts. how do I find out about the solubility of drugs?

10/10- lithium(300mg)-began taper ~2/12 at 10% per 10 days to 2 wks
12/10- emsam(12mg patch)-began taper 12/12 over 4 months
1/11- lamictal(150mg)-began taper 12/12 tapered rapidly over one month
2006-seroquel(250mg max dose)-began taper 10/11 at 10% per 10 days to 2wks until current dose of 50mg.
10/12-viibryd-began taper 4/27/13 and ended in 47 days
1989- temazepam 30mg began taper 12/12

3/10 Ativan .5-2mg prn began microtaper 7/11 from 1.5mg

3/13 trazadone(100mg) added for sleep

26 yrs polypharm. ECT

Seroquel 50mg  Ativan1.66mg  trazadone 72mg  crossed temaz to Ativan 3/14. held 2 mos
 

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I Google to find solubility information.

 

For example, see http://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/022421s000chemr.pdf

 

a 2010 document submitted by the manufacturer to the FDA:

 

Pramipexole dihydrochloride monohydrate is freely soluble in water and methanol (> 20 mg/mL) andslightly soluble in 96% ethanol (~18 mg/mL). Its solubility in buffer media is well above 10 mg/mLbetween pH 1 and pH 7.5. A saturated aqueous solution of the drug substance has a pH value of 3.3. Thehigh permeability and the high solubility classify pramipexole dihydrochloride monohydrate as a BCSclass 1 drug substance. Pramipexole dihydrochloride monohydrate drug substance is a very stablecompound. In the solid state and in solutions stored at ambient temperature, pramipexoledihydrochloride monohydrate does not degrade.

 

As our esteemed member Rhi has pointed out, solubility is not much of an issue. You can make a suspension of drugs that are relatively insoluble, as long as you crush them and mix them well in the suspension fluid.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you Alto and Rhi. I was thinking along the lines of Rhi but wasn't sure. Very good to know.

10/10- lithium(300mg)-began taper ~2/12 at 10% per 10 days to 2 wks
12/10- emsam(12mg patch)-began taper 12/12 over 4 months
1/11- lamictal(150mg)-began taper 12/12 tapered rapidly over one month
2006-seroquel(250mg max dose)-began taper 10/11 at 10% per 10 days to 2wks until current dose of 50mg.
10/12-viibryd-began taper 4/27/13 and ended in 47 days
1989- temazepam 30mg began taper 12/12

3/10 Ativan .5-2mg prn began microtaper 7/11 from 1.5mg

3/13 trazadone(100mg) added for sleep

26 yrs polypharm. ECT

Seroquel 50mg  Ativan1.66mg  trazadone 72mg  crossed temaz to Ativan 3/14. held 2 mos
 

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