Hi there,

I'm a student of pharmacology, and my advice is not intended to substitute the advice from your physician. My intention is to help clarify the drug itself and suggest some possible, prescription medication treatments.

Gabapentin was originally designed as an anticonvulsant. It is analogous to the neurotransmitter GABA, the relaxation chemical in the central nervous system, however it does not increase GABA concentrations nor act on GABA receptors. It works by decreasing electronic transmissions between neurons. It's used for epilepsy, RLS (usually as a first line agent), diabetic neuropathy, and off-label for some psychiatric conditions like anxiety.

600 mg/day to start with is relatively standard. 1800 mg/day is high, but safe. I've actually seen higher doses. Always be on the lookout for depressive thoughts or feelings as gabapentin is known to cause these, albeit somewhat rarely. I personally don't have RLS, and I am sorry you're experiencing such symptoms. RLS is a spectrum disease, and it affects patients very differently from patient to patient. Your treatment needs to be one that is tailored for you. Gabapentin alone helps some people, but for many another medication is needed in addition to it. Another first line treatment is a RX known as a dopamine agonist, an example being pramipexole. Levodopa, the levoratory form of dopamine, is also effective. These do require prescriptions. For pain issues, carbamazepine, an anticonvulsant, is effective. Less conservative treatments include Valium (diazepam), a benzodiazepine drug that enhances GABA transmission in the brain (however, it is a controlled drug that can be addicting). It would be particularly helpful if you experience sleep disturbance. An even less conservative option would be opioids like hydrocodone, but these are reserved for treatment resistant RLS.

I recommend documenting every symptom you are experiencing, and note its severity. Presenting this to your doctor will help them determine if a combination of meds is better than one. RLS is multidimensional, and it has to be treated using more than one approach at times. Work with your doctor on developing a tailored treatment regimen just for you. It seems gabapentin may be only addressing one issue out of many.

Best!