# Experiences with Pramipexole?



## Rymdis (Mar 14, 2010)

Hi there!

Im on Pramipexole and im interested in you who can share your experience from this med. 

Im on day twelve now and feel like really bad. It doesnt seem to go away. Anxious and tired but cant sleep. Maybe i titrated to fast? Now i take 0.18mg three times a day.

Perhaps it will change soon but its always a good relief hearing from others.

Many many thanks!

/R


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## crayzyMed (Nov 2, 2006)

You could drop a PM too Guide4Dummies, he also noticed a big increase in anxiety and feeling worse the first days, after that it went away and felt better. Or check the message on your profile, could bring you guys in contact.

How long have you been on the same dose?


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## Rymdis (Mar 14, 2010)

crayzyMed said:


> You could drop a PM too Guide4Dummies, he also noticed a big increase in anxiety and feeling worse the first days, after that it went away and felt better. Or check the message on your profile, could bring you guys in contact.
> 
> How long have you been on the same dose?


Ive already talked to him, but thanks anyway! I guess that the med is restructure *something* anyway. Are there others who have tried this med? I guess next stop, and perhaps final, is Ritalin. The thing is that i also stutter a lot worse then before. According to some reports stutters have a higher D2 receptor bindings than normal people. Talk about an ironic situation 

/R


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## crayzyMed (Nov 2, 2006)

> According to some reports stutters have a higher D2 receptor bindings than normal people.


Depends what causes the stuttering, sometimes SA causes ppl to stutter, other ppl stutter without having social anxiety.

Your dose is probably still to low to effectivly agonize the postsynaptic receptors leaving you with activated presynaptic receptors wich lower dopamine release, those should downregulate tough.

Anyway, it appears that after 2 weeks on a certain dose the autoreceptors should be fully downregulated, so once youv stayed on 0.18mg for 14 days and you still feel bad id try something else.


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## Rymdis (Mar 14, 2010)

crayzyMed said:


> Depends what causes the stuttering, sometimes SA causes ppl to stutter, other ppl stutter without having social anxiety.
> 
> Your dose is probably still to low to effectivly agonize the postsynaptic receptors leaving you with activated presynaptic receptors wich lower dopamine release, those should downregulate tough.
> 
> Anyway, it appears that after 2 weeks on a certain dose the autoreceptors should be fully downregulated, so once youv stayed on 0.18mg for 14 days and you still feel bad id try something else.


yep, perhaps thats the case. i thought that two weeks with titration included was the case but maybe not? Well, i have been worse so...
Taking Klonopin and Valium just to hang in there and Remeron to be able to sleep at all.

Wonder how fast you can titrate this med though? I want to hit 0.27*3.

/R


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## crayzyMed (Nov 2, 2006)

Rymdis said:


> yep, perhaps thats the case. i thought that two weeks with titration included was the case but maybe not? Well, i have been worse so...
> Taking Klonopin and Valium just to hang in there and Remeron to be able to sleep at all.
> 
> Wonder how fast you can titrate this med though? I want to hit 0.27*3.
> ...


No, if you up the dose the downreceptors would have to downregulate again, you have to stay 2 weeks on the same dose, since you get alot of side effects i wouldnt change the dose for now.

Titration with this med is done very slowly to avoid side effects, i think for parkinson they up with 0.125 every week.


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## Rymdis (Mar 14, 2010)

crayzyMed said:


> No, if you up the dose the downreceptors would have to downregulate again, you have to stay 2 weeks on the same dose, since you get alot of side effects i wouldnt change the dose for now.
> 
> Titration with this med is done very slowly to avoid side effects, i think for parkinson they up with 0.125 every week.


Ok, then i have been too fast  Maybe that adds even more sh*t 

But 0.18*3 is still a very low dose so if i wait 2 weeks i might not be able to feel anything 

/R


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## crayzyMed (Nov 2, 2006)

Rymdis said:


> Ok, then i have been too fast  Maybe that adds even more sh*t
> 
> But 0.18*3 is still a very low dose so if i wait 2 weeks i might not be able to feel anything
> 
> /R


The most important thing now is too see wheter you will adapt to the side effects, when you realise they would go away it would be easier to taper after that.


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## Rymdis (Mar 14, 2010)

crayzyMed said:


> The most important thing now is too see wheter you will adapt to the side effects, when you realise they would go away it would be easier to taper after that.


well, maybe i should feel *something *from 0.18*3 so maybe its best to wait a few weeks to see. But patience is not my strongest side 

and then if i dont feel anything its titrate again and even more weeks 

/R


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## crayzyMed (Nov 2, 2006)

Rymdis said:


> well, maybe i should feel *something *from 0.18*3 so maybe its best to wait a few weeks to see. But patience is not my strongest side
> 
> and then if i dont feel anything its titrate again and even more weeks
> 
> /R


Yeah, youll need patience with it You could titrate up faster but the side effects can get whorse.


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## Rymdis (Mar 14, 2010)

crayzyMed said:


> Yeah, youll need patience with it You could titrate up faster but the side effects can get whorse.


Dont think they get worse than this  The problem is, and from what i read and talked to you about, is that initially it lowers the DA and NA and i guess this is the case of the bad feelings. I think i already have low DA so in my case lowering this even more, and i think it was by 30% or so, will of course have some effect on me. I dont know if its the dose that regulates how much its lowered though. Maybe a titrate of 0.09*3 will make me feel better?

With parkinson 0,088mg*1 is recommended the first week and 0.18*3 the second week. the third week is 0,35mg*3. (Info from the manufacture)

With restless legs its lower though.

Guide4Dummies is taking 0.75mg a day divided into three.

But who knows whats working 

Ive had many side-effects through the years so im quite harden. Even woke up one day but couldnt move, just see. I tried to move but couldnt. Thought i was poisoned or dead.
But that was with a high dose of effexor and remeron 

But there must be more than two in this forum eating this 

/R


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## crayzyMed (Nov 2, 2006)

The lower you start the less side effect you would have. Yeah initially it can lower dopaminergic transmission with 40%.

There only are 2 people, its because only recently after a paper that was published showing dopamine is connected with social status ppl started trying new things.


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## karoloydi (Feb 18, 2010)

Rymdis said:


> Ive already talked to him, but thanks anyway! I guess that the med is restructure *something* anyway. Are there others who have tried this med? I guess next stop, and perhaps final, is Ritalin. The thing is that i also stutter a lot worse then before. According to some reports stutters have a higher D2 receptor bindings than normal people. Talk about an ironic situation
> 
> /R


Thats interesting. The last time I took sinemet (l-dopa) I had some minor stutter a couple of times. I ve never stuttered before in my life. I dont know if its related, but that was the only time I didnt take 5-HTP with it.

About the side effects in the first weeks, what if we took a really small dose of something like wellbutrin or sinemet to help with the symptoms?


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## Rymdis (Mar 14, 2010)

karoloydi said:


> Thats interesting. The last time I took sinemet (l-dopa) I had some minor stutter a couple of times. I ve never stuttered before in my life. I dont know if its related, but that was the only time I didnt take 5-HTP with it.
> 
> About the side effects in the first weeks, what if we took a really small dose of something like wellbutrin or sinemet to help with the symptoms?


well, i have wellbutrin at home. could start a little pharmacy i think 

when i used Wellbutrin it was with efexor and 150mg was ok but didnt help much. 300mg made me somewhat anxious. Dont know if its ok to counteract the side-effects i have now. But it should raise the dopamine i guess so on paper it may work. Might try that. Guess there are no interactions either. Although its a weak dopamine agonist what ive heard.

maybe someone else knows better?

/R


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## crayzyMed (Nov 2, 2006)

Rymdis said:


> well, i have wellbutrin at home. could start a little pharmacy i think
> 
> when i used Wellbutrin it was with efexor and 150mg was ok but didnt help much. 300mg made me somewhat anxious. Dont know if its ok to counteract the side-effects i have now. But it should raise the dopamine i guess so on paper it may work. Might try that. Guess there are no interactions either. Although its a weak dopamine agonist what ive heard.
> 
> ...


Theoretically it should be safe, i would be very carefull with this combo, start very slow.


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## Rymdis (Mar 14, 2010)

crayzyMed said:


> Theoretically it should be safe, i would be very carefull with this combo, start very slow.


150mg is quite low so maybe that will give me a hint of where its going.

Doesnt know too much about wellbutrin though. What is the mechanism and what does it affect? Is it DA and NA?

I also read a repport that stutters are likely have too high glutamine levels. So Memantine may strike two in one then. My ocd and stutter 

/R


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## crayzyMed (Nov 2, 2006)

Rymdis said:


> 150mg is quite low so maybe that will give me a hint of where its going.
> 
> Doesnt know too much about wellbutrin though. What is the mechanism and what does it affect? Is it DA and NA?
> 
> /R


Its primilary a NE reuptake inhibitor with some effect on dopamine, should help with the sedation.


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## karoloydi (Feb 18, 2010)

I ve ordered pramipexole today. Probably wont receive it until next month. Those online pharmacies are painfully slow to deliver. 
What titration method would you guyz recommend? How many mg per day? The psychological side effects are not really my main concern. My blood pressure is a bit low, so I need to make it as safe as possible. 

How does this sound?
Week 1: 0.25 mg a day (2x0.125)
Week 2: 0.375 mg a day (3x0.125)
Week 3: 0.5 a mg day (2x0.25)
Week 4: 0.75 mg a day (3x0.25)

Or:

Week 1: 0.125 mg a day (1x0.125)
Week 2: 0.25 mg a day (2x0.125)
Week 3: 0.375 a mg day (3x0.125)
Week 4: 0.5 mg a day (2x0.25)
Week 5: 0.625 mg a day (2x0.25 + 1x0.125)
Week 6: 0.75 mg a day (3x0.25)


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## crayzyMed (Nov 2, 2006)

Id start even lower and carefully monitor your blood pressure, in your case being extra carefull is a good idea. 0.25 alone causes some bad sedation from what ive read the first time, so it could lower NE alot.


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## karoloydi (Feb 18, 2010)

crayzyMed said:


> Id start even lower and carefully monitor your blood pressure, in your case being extra carefull is a good idea. 0.25 alone causes some bad sedation from what ive read the first time, so it could lower NE alot.


It will be hard to cut the 0.25mg pill in more than two pieces. I ve ordered some wellbutrin as well. So, if I see my blood pressure dropping too much wellbutrin should put it back higher again. I ll also increase my salt intake.


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## Rymdis (Mar 14, 2010)

Guide4Dummies didnt titrate at all actually. He started with 0.25*3 a day 

This slow titrate is like slow torture actually. I only want to know if hte med is working so ill titrate 0.09*3 today along with 150mg wellbutrin. keep you posted how that goes. If you heard nothing today it didnt go so well 

/R


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## podizzle (Nov 11, 2003)

guess it didnt go so well.


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## Rymdis (Mar 14, 2010)

ive forgot about this thread  Been in hell and back sort of. This med is not kidding around with. I titrated to 0.18mg*3 a day and then after a few days to 0.27mg*3 a day. Wasnt feeling anything really besides the initial side-effects. Extreme insomnia, no apetite, irritation, increased anxiety and so on  After about one week on this i added Memantine which was a big mistake for me. Anxiety through the roof and i stopped after 4 days i think. After another week i began to feel worser and worser. The last 3 days have been horrible. But...today i lowered the dosage to 0.18mg*3 and what a difference. I guess i got too much dopamine going on in my brain. Think twice before you take this med. And titrate slowly! Maybe less is more... some may need higher dosages but not everybody!

For now im ok but i really dont see any improvement in SA. maybe my DA levels were good from the beginning? Ill stick to this a bit longer just in case.

I know people here have been 100% cured by this med but i also seen many being cured by Zoloft, Efexor, Remeron and take your pick 

Were all different!

/R


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## karoloydi (Feb 18, 2010)

Rymdis said:


> ive forgot about this thread  Been in hell and back sort of. This med is not kidding around with. I titrated to 0.18mg*3 a day and then after a few days to 0.27mg*3 a day. Wasnt feeling anything really besides the initial side-effects. Extreme insomnia, no apetite, irritation, increased anxiety and so on  After about one week on this i added Memantine which was a big mistake for me. Anxiety through the roof and i stopped after 4 days i think. After another week i began to feel worser and worser. The last 3 days have been horrible. But...today i lowered the dosage to 0.18mg*3 and what a difference. I guess i got too much dopamine going on in my brain. Think twice before you take this med. And titrate slowly! Maybe less is more... some may need higher dosages but not everybody!
> 
> For now im ok but i really dont see any improvement in SA. maybe my DA levels were good from the beginning? Ill stick to this a bit longer just in case.
> 
> ...


What you said about memantine made me think. Would it be a good idea to start memantine before you start prami, or after?
I am thinking that maybe memantine wont let the autoreceptors to upregulate. So maybe it would be a good idea to start taking it after the autoreceptors have already upregulated.


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## crayzyMed (Nov 2, 2006)

karoloydi said:


> What you said about memantine made me think. Would it be a good idea to start memantine before you start prami, or after?
> I am thinking that maybe memantine wont let the autoreceptors to upregulate. So maybe it would be a good idea to start taking it after the autoreceptors have already upregulated.


I agree, Guide4dummies also tolled me that he adapts faster without memantine.


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## Rymdis (Mar 14, 2010)

rocknroll714 said:


> Your dose is too low/you haven't given the prami enough time to kick in. It can take as long as 4 weeks for benefits to fully come to prominence. The reason you felt good when you lowered the dose is because you weren't adapted all the way and your dopamine levels were actually _lower_ than usual. By dropping the dose you increased them. So don't give up on it yet!


But i cant explain that i was feeling worse and worse at the end. Shouldnt this be the other way around? As the DA slowly increases to normal? Ive been on it for such long time so i guess the DA had time to fully recover. I felt during this time pretty ok for a few days, and i guess thats when the DA were in balance. It still *could* be that my DA levels were too high that made me feel better lowering the dosage. But it could also be the other option.

Btw, whats a low dosage for SA on this med as there are almost nobody that have tried it yet 
Maybe this is based on clinical studies? Whats considered a "normal" dosage then?

And i guess that if i titrate back to 0.27mg again it will restart the process and ill have to wait like 3-4 weeks before i could tell? Thats how it works, or?

Update on my SA today: Feeling sh*t! But hey, im messing with my brain. What should i expect  So do i have too little DA now or too much?

Is there an adapt period on lowering dosages as well?

/R


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## karoloydi (Feb 18, 2010)

Guide 4 Dummies said:


> Are you a smoker?
> 
> I've noticed that on the following day I smoke tobacco/nicotine, the good effects of Pramipexole go away, and the side effects return. For instance, I smoked yesterday, so today SAD is back as well as side effects. Tomorrow I will feel fine again.
> 
> This indicates an interaction between nicotine and Pramipexole.


Maybe anything that increases dopamine causes that. Maybe next day the autoreceptors have to upregulate again.


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## Rymdis (Mar 14, 2010)

well i use snuff instead of smoking. And i snuff all the time. Also drick coffee. Bad combo or? 

So if i use nicotine i this will not work. And the same goes with coffe, or?

You talk about that the Prami has to upregulate the autoreceptors in the DA. So if i drink coffee that increases DA then i have too much and that will cause a problem, right?

And if i use nicotine this will somehow lower the DA levels in the brain.

Am i only feeling bad when the actual "action" takes place? i.e. the reglation of the receprors.

Update for my status: Really really sh*t!!!!!!!!!!!! I have to take benzos just to bare with it. And this just take the edge of it. But i guess its the day after modification things happen for some reason. Can add that under the entire treatment i misspell words all the time. Never happened before.

To describe the feeling somehow: Extreme anxious, feeling speeded, irritated and just walk around the apartment hoping for it to go away, but it doesnt. Dont know what to do to get rid of it and i just want to go to bed so it can go away but i cant sleep!

I guess i would be easy to determine if the DA is too high by just taking a DA antagonist. I have 5 different ones at home 

/R


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## euphoria (Jan 21, 2009)

Tobacco is an enzyme inducer, when smoked. It could be causing your drugs to be cleared more rapidly. When used by other means, it has a lesser and probably irrelevant effect on enzymes.


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## Rymdis (Mar 14, 2010)

could anyone please comment my last post. 

thanks
/R


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## karoloydi (Feb 18, 2010)

Guide 4 Dummies said:


> Seems to be the only explanation. Afterall, nicotine is a mild releaser through nicotinic acetylcholine receptors and tobacco has MAO inhibition properties. The presynaptic receptors will downregulate soon after the upregulation.


So it seems like while you are adapting to the drug its better to be patient and wait rather than try to find ways/drugs to fight the side effects. Otherwise you are just prolonging the side effects. I was thinking of using wellbutrin or sinemet for the side effects, but now I am thinking that it wont be such a good idea after all.
I ve been reading in another forum that provigil could help with the lethargy experienced in the adaptation period. But I am not so sure about this either. Cause people have also been reporting that they have problem sleeping at night with prami. So adding provigil to the equation could make insomnia even worse.


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## Rymdis (Mar 14, 2010)

Nobody wants to comment and answer my post? Please please with sugar on top 

/R


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