Some things that happened when I started smoking again...

[Wozlik]

II'm just beginning to be able to figure some of this out, so I'm writing this mostly for myself.

loved being a nonsmoker.  It took a while before I started feeling the effects, but not too long into my quit I noticed that my brathing was a bit better. A little later my cough slowed down, became less productive. Eventually it stopped. The pain I had from my dental implants disappeared.  My sinuses cleared up.  I had some energy.  Everyday I was grateful that this miracle had occurred. Then I had my slip.  I don't remember whey, but it wasn't for any good reason.  I was probably uncomfortable, unsettled, scared or something that made me feel I didn't have control.  Smoking seemed like the only thing I could do.  It wasn't, but I didn't see that.

I quickly, and was proud of myself.  It was really cool not smoking.  I felt good - physically and mentally.  I felt like I could make the choice not to smoke and it made me stronger.  I don't think I've ever felt that way.  Folks here were supportive and wonderful and encouraging and understanding.  I felt like I was home.

Then I misunderstood directions from a doctor.  I take a drug for restless legs.  It's ropinerole and I've been on it for at least 25 years.  It's a dopamine agonist, and while I really don't understand what that does, the Cleveland Clinic says "Dopamine agonists are drugs that mimic the natural neurotransmitter dopamine. Dopamine agonists bind to and activate the dopamine receptors on nerve cells in your brain, causing nerve cells to react in the same way as they would to natural dopamine.

As a neurotransmitter, dopamine is involved in:

• Movement.
• Memory.
• Pleasurable reward and motivation.
• Behavior and cognition.
• Attention.
• Sleep and arousal.
• Mood.
• Learning."

The Mayo Clinic says that side effects of ropinerole include:

1. Confusion
2. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
3. drowsiness
4. falling
5. nausea
6. seeing, hearing, or feeling things that are not there (hallucinations)
7. sleepiness or unusual drowsiness
8. swelling of the legs
9. twisting, twitching, or other unusual body movements
10. unusual tiredness or weakness
11. worsening of parkinsonism

Less common

1. Bloating or swelling of the face, arms, hands, lower legs, or feet
2. blood in the urine
3. blurred vision
4. burning, pain, or difficulty in urinating
5. chest pain or tightness
6. chills
7. cold sweats
8. cough
9. double vision or other eye or vision problems
10. fainting
11. fear or nervousness
12. feeling of constant movement of self or surroundings
13. high or low blood pressure
14. irregular or pounding heartbeat
15. loss of memory
16. mental depression
17. pain in the arms or legs
18. pounding in the ears
19. rapid weight gain
20. sensation of spinning
21. slow or fast heartbeat
22. sore throat
23. stomach pain
24. sweating
25. tingling of the hands or feet
26. tingling, numbness, or prickly feelings
27. trouble in concentrating
28. trouble breathing
29. unusual weight gain or loss
30. vomiting

Rare

1. Anxiety
2. buzzing or ringing in the ears
3. changes in vision
4. fever
5. headache
6. joint pain
7. loss of bladder control
8. muscle cramps, pain, or spasms
9. runny or stuffy nose
10. sneezing
11. trouble with swallowing
12. unusual urges"

Because I've had many of these issues since getting Covid in March 2020 my neurologist and sleep doctore talked to me about getting off ropinerole in order to do a study for narcolepsy.  The paper from my neurologist says "get MSLT.  D/C ropinerole.  Horizant.  I got the first two parts.  I called the sleep doctor and talked about scheduling the MSLT and I discontinued the ropinerole.  

Discontinuing ropinerole cold turkey is not recommended.  Good RX says "Talk to your provider if you're interested in stopping ropinirole. Your provider will work with you to come up with a plan to safely stop the medication. This typically involves slowly lowering the dose over a period of time so the dopamine levels in your brain don't drop too quickly. Stopping ropinirole too suddenly can cause your PD or RLS symptoms to come back. Additionally, you can have withdrawal symptoms (e.g., anxiety, distress) or a serious side effect called neuroleptic malignant syndrome that causes high fever, muscle stiffness, and confusion."  and the Mayo Clinic says "Talk to your provider if you're interested in stopping ropinirole. Your provider will work with you to come up with a plan to safely stop the medication. This typically involves slowly lowering the dose over a period of time so the dopamine levels in your brain don't drop too quickly. Stopping ropinirole too suddenly can cause your PD or RLS symptoms to come back. Additionally, you can have withdrawal symptoms (e.g., anxiety, distress) or a serious side effect called neuroleptic malignant syndrome that causes high fever, muscle stiffness, and confusion."

So my quitting the medication was not helpful not conducive to my quit.  More to follow.

Scientific American says: "nicotine stimulates the release of dopamine in neurons that connect the nucleus accumbens with the prefrontal cortex, amygdala, hippocampus, and other brain regions; this dopamine signal “teaches” the brain to repeat the behavior of taking the drug."  It's an older articles, but here's the link if you are interested: https://blogs.scientificamerican.com/observations/recent-research-sheds-new-light-on-why-nicotine-is....

 More to follow