Restless legs syndrome (RLS) and mirtazapine

Hi All, I landed here in my quest for information about the correlation between mirtazapine and RLS. The latter had never been an issue for me before starting the mirtazapine. I have been on my current regimine for some time now (over a year) and it hasn't subsided.
For me, taking the med earlier is counter-productive to my sleep. I need to hit that "window" of 20-30 minutes between taking the med and going to bed for optimal sleep.
I wanted to share something that has been helping: I have one of those wedge pillows, and I recently started sleeping with my legs elevated on the wedge...it's really helping! I'm sure there is a solid physiological explanation but I haven't researched it, I'm just relieved to have something that helps.
I do walk regularly. I have a large breed dog (Cane Corso) who needs a lot of exercise, so she makes me get out for an hour or two every day.
Another thing I'm going to try is a weighted blanket. I have one, just have it stowed away somewhere. I love it for other reasons (really does feel like a hug, helps with my anxiety), it's just that my current living situation is temporary and cramped so I have been operating with the basics.
Lastly, my doc is starting me on vistaril PRN today. I have been advised that I can take it every night, once a month, or any frequency in between without concomitant effects.
Just wanted to share my experiences as I continue to find resolution for this most annoying issue, and learn from this community.
V.

Hello @vhn, Welcome to Mayo Clinic Connect. Thank you for sharing your experience with RLS and mirtazapine and tips with what helps you. I also sleep with my legs slightly elevated to help with swelling and circulation problems (lymphedema). Here's some information on the topic - What Are the Benefits of Elevating Your Legs? - https://www.healthline.com/health/elevating-legs

Do you mind sharing what you were searching for when you found Connect?

Hi John,

Thank you for the warm welcome and the additional info!

I found Connect simply by Googling "mirtazapine and RLS." I selected the Mayo Connect search result based on my familiarity with the Mayo Clinic's stellar reputation.

Kind Regards,

Vanessa

Hello, Vanessa and John. @vhn, @johnbishop. I have severe restless leg syndrome diagnosed at the Mayo Sleep Dept during a sleep study a couple years ago. I've had this issue for years, never addressed. The sleep staff did some bloodwork and found I have a very low ferrous level....iron deficiency, often found with RLS. I take Vitron, iron plus C that helps with absorption. Wow, did that help and make a big difference, i.e. RLS lessened and fatigue and other iron deficiency symptoms improved. Also, I'm taking Requip, dopamine enhancer. Another great find! No more RLS, between the two, the problem is controlled.

AND, side effects from both are good for me! I apparently am benefiting from the improved dopamine. No more tremors, only on first waking and/or when more anxious than normal, feet work better and hurt less, legs aren't feeling like or acting like tree trunks, walk better, stand straighter most of the time. In general, my legs and feet and toes are all improved, and more energy, less anxiety and better outlook on the world.

And, I think I'm better in lots of ways due to the b-pap for severe apnea. Also, Vanessa, I'm using MMJ, 1:1 tincture, at bedtime, for pain and anxiety and sleep..... Helps a bunch!

Since I have reflux and have those wedge pillows under my mattress head, I can't elevate my feet too well! But, do elevate every chance during the day. It's a requirement for me now, for edema and blood flow, neuropathy.

Don't know if you can benefit from any of my experiences and finds, hope so. It's amazing how we help each other. And, you're so right about Mayo. That one dept study re sleep apnea led to diagnosis, treatment and relief from RLS, helps with neuropathy, fatigue and all the other side effects that have made a big difference.
Blessings and may your journey continue to lead to good folks and good progress. elizabeth

Hello, Vanessa and John. @vhn, @johnbishop. I have severe restless leg syndrome diagnosed at the Mayo Sleep Dept during a sleep study a couple years ago. I've had this issue for years, never addressed. The sleep staff did some bloodwork and found I have a very low ferrous level....iron deficiency, often found with RLS. I take Vitron, iron plus C that helps with absorption. Wow, did that help and make a big difference, i.e. RLS lessened and fatigue and other iron deficiency symptoms improved. Also, I'm taking Requip, dopamine enhancer. Another great find! No more RLS, between the two, the problem is controlled.

AND, side effects from both are good for me! I apparently am benefiting from the improved dopamine. No more tremors, only on first waking and/or when more anxious than normal, feet work better and hurt less, legs aren't feeling like or acting like tree trunks, walk better, stand straighter most of the time. In general, my legs and feet and toes are all improved, and more energy, less anxiety and better outlook on the world.

And, I think I'm better in lots of ways due to the b-pap for severe apnea. Also, Vanessa, I'm using MMJ, 1:1 tincture, at bedtime, for pain and anxiety and sleep..... Helps a bunch!

Since I have reflux and have those wedge pillows under my mattress head, I can't elevate my feet too well! But, do elevate every chance during the day. It's a requirement for me now, for edema and blood flow, neuropathy.

Don't know if you can benefit from any of my experiences and finds, hope so. It's amazing how we help each other. And, you're so right about Mayo. That one dept study re sleep apnea led to diagnosis, treatment and relief from RLS, helps with neuropathy, fatigue and all the other side effects that have made a big difference.
Blessings and may your journey continue to lead to good folks and good progress. elizabeth

Elizabeth,

Thank you for sharing your experiences! I'm actually scheduled for blood work, so the timing is great for me to bring this to my doctors' attention when reviewing the results. My grandmother has had to have blood infusions for iron deficiency. She's nearly 93, but there still is the possibility that there is a genetic component to my RLS experiences beyond aging.

Forgive my ignorance, I'm not familiar with MMJ? Google leads me to believe it is medical marijuana derivatives?

I still have intermittent neuropathy, too, following a MVA. I started on Gabapentin initially to address the neuropathy, without understanding until later that Gaba also helps with anxiety. I continue to take Gabapentin on the regular, and definitely notice if I miss too many doses.

I work in BioPharma, so I'm always intrigued to learn what works AND WHY! LOL

I'm so glad, Elizabeth, that you have found some relief and a proper diagnosis. It's a pleasure to "meet" good folks along the journey. I will keep you posted on my journey to wellness. I wish you continued good health!

Kind Regards,

Vanessa

@vhn, @johnbishop, @lioness, @suecreader, @artscaping
Vanessa, I forgot to mention the MMJ....medical marijuana. I've used it in some form for several years, but only this year after learning from several folks on Connect, especially a special lady, Chris Trout @artscaping, have I found the best way for me to get the most benefit. I use a 1:1 tincture under my tongue when I begin getting ready for bed every night. 1:1, THC:CBD, with no effects other than a decrease in anxiety, reduction in pain, help with sleep. This added to my regular drugs, including Robaxin for cramping back/leg/other muscles, 2Xdaily, Cymbalta a.m. only for anxiety and fibromyalgia - helps!, an occasional extra strength Tylenol if pain is worse than usual. Vanessa, I'm off a bunch of pain meds and others I've been on for years because of the addition of MMJ used like this. Not tablets, as tincture is much faster acting and helpful at night.

I also use a tiny spray of THC during the day if pain is worse, and a half dropper of CBD only tincture for anxiety if needed. I have only good results. I want no recreational effects, don't get them, but do have medical help better than any other.

So, there you go. Hope this helps. Blessings to you!
elizabeth

I’m considering starting remeron for depression but I do have restless legs already…..I don’t want that to get worse! How have you been and did you stay on remeron?