RLS & Pregabalin
Hey everyone! Just writing here to seek guidance and want to hear about your experience with treating RLS with pregabalin.
I'm a 32M who has struggled with RLS basically my whole life but it wasn't very severe until my 20's. It would only really flare up if I was really tired to the point of falling asleep, and it's always my right leg for some reason?
(for info, I have had my iron levels checked and they are within spec)
I'm also diagnosed ADD and cPTSD and use Elvanse (European Vyvanse) dosed at 50mg and I take it in the mornings.
I struggle a lot with getting tired and falling asleep in general and have struggled with an insomnia like diagnosis for a really long time. (Due to anxiety, and others). I was started on Cipralex(Escitalopram) back in 2020 to help with my cPTSD but that made my RLS way worse and would struggle even more with my sleep. It's no joke either, my right leg is essentially kicking hard what feels like on interval and it's really uncomfortable. So I quit the SSRI's but that didn't really help, sure it wasn't every night but it was more often than before starting the SSRI's.
To manage my sleep issues I've tried magnesium and melatonin but melatonin really set off my RLS so had to stop that too.. then I got prescribed Seroquel(Quetiapine) 25-50mg at night for the insomnia back in 2022 which works like a charm but of course that too really triggers my RLS but I've just dealt with it cause it legitimately makes me tired and eventually makes me fall asleep but at the end of 2025 I set my foot down and said enough is enough and contacted my doctor and I told her that I've been suffering from this for as long as I can remember and having problems with sleep ontop of that made me go to my wits end. I got prescribed Gabapentin 300mg at first which unfortunately didn't have any effect on the RLS, then she suggested pregabalin but having heard how addicting it is and such I was very reluctant so I asked if there was a possibility to up the Gabapentin dose to give it a last try so it was upped to 600mg which didn't have any effect either so eventually I gave in and got prescribed Pregabalin 75mg capsules.
I had mixed results with the 75mg dosage as sometimes it gave full relief while other times it just suppressed the RLS a tiny bit so that the "intervals" were further apart, so after that I was upped to 150mg and I've had somewhat good effect on that and I don't suffer nearly as much as I did prior to upping the dosage. But it seems really hit or miss for me? Like, I take the pregabalin around 9PM since I know it takes like 2-2.5 hours to work then aim to go to bed around midnight. Sometimes it gives relief through the whole night while other times it doesn't give relief at all and feels like the effects of the pregabalin has already worn off but that's literally impossible?
The only thing I can think of is that the days I have full effect are days where I take it on a completely empty stomach because I've forgotten to eat all day due to the vyvanse doing it's thing but days where I eat dinner or something between 5 and 7PM then it doesn't seem to work at all. Does taking it with food in my stomach really delay the onset THAT much?? Is there anything I can do to make it act faster without having to completely starve myself after midday??
edit: I do realize I could take it earlier in the day but then I also risk the effects will be worn off by the time I go to sleep due to the short half-life of the medication..
I do apologize for the long post, hope to see your responses! 🙏🏻