1. < Depression & Anxiety

Restless legs syndrome (RLS) and mirtazapine

Posted by rw @rwlovell, Jun 30, 2017

Hi,
I recently started mirtazapine and have had a good initial reaction to the drug - my energy is better, my mood. The one rather major problem is it seems to trigger or exacerbate my RLS. I had been on tramadol (for back pain) about a week before starting mirtazapine and I have read that they can interfere with each other and cause RLS. My question is should I look for another antidepressant or is it possible that this will improve with time. Right now I am awake all night until about 5 AM when I catch a few hours of sleep. It is pretty rough.

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laurine7 | @laurine7 | Apr 2, 2022

Research your RLS online http://www.rls.org before you get on any benzodiazepines (Diazepam). 15 years ago I started Lorazepam my Doctor prescribed and it was a God Sent, slept all night all the while I was not it. My UCSF Psychiatrist told me it is a dangerous drug, you need to get off of it. That was 11 months ago, the withdrawal and then tapering was a nightmare. You need to do all the search you can, first the benzodiazepine drug side effects etc. RLS deprives you of your sleep and your body cannot heal without sleep. My RLS came back and I rub VOLTAREN GEL ON WHICHEVER LEG WONT STOP. The only problem now is they no longer have it as a prescription and the OTC is less potent and takes longer to take affect. I am going to try Living Water I read about on Mayo Connect. Good Luck. P.S. You can research Benzos at https://www.benzoinfo.com/

REPLY
tim1028 | @tim1028 | Apr 27, 2022

As someone who has RLS, may I offer a couple of suggestions:

There is a national RLS organization, http://www.rls.org which has an abundance of free information. Most PCPs and many neurologists have thin knowledge about RLS and are regrettably often not good resources for treatment. The RLS Foundation has identified 12 Quality Care Centers throughout the U.S. (of course, the wonderful Mayo Clinic in Rochester, MN, my birthplace, is on the list). These centers are the REAL experts on RLS. One of the first lines of approach to RLS treatment is to check the ferritin level to ensure that it is high enough (for RLS it is recommended to aim for a value of 100 or higher), and take supplemental oral iron to increase it as needed. This in itself may alleviate RLS symptoms totally or to a great extent.

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1 reply
Mentor
Merry, Volunteer Mentor | @merpreb | Apr 27, 2022
In reply to @tim1028 "As someone who has RLS, may I offer a couple of suggestions: There is a national..." + (show)
@tim1028

As someone who has RLS, may I offer a couple of suggestions:

There is a national RLS organization, http://www.rls.org which has an abundance of free information. Most PCPs and many neurologists have thin knowledge about RLS and are regrettably often not good resources for treatment. The RLS Foundation has identified 12 Quality Care Centers throughout the U.S. (of course, the wonderful Mayo Clinic in Rochester, MN, my birthplace, is on the list). These centers are the REAL experts on RLS. One of the first lines of approach to RLS treatment is to check the ferritin level to ensure that it is high enough (for RLS it is recommended to aim for a value of 100 or higher), and take supplemental oral iron to increase it as needed. This in itself may alleviate RLS symptoms totally or to a great extent.

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Good morning @tim1028. This is good information but I must say that no one should take these supplements without having blood work first! Taking any supplemental ferritin without needing it can send the entire body out of whack!

Please be careful. Don't you agree?

REPLY
1 reply
tim1028 | @tim1028 | Apr 27, 2022
In reply to @merpreb "Good morning @tim1028. This is good information but I must say that no one should take..." + (show)
@merpreb

Good morning @tim1028. This is good information but I must say that no one should take these supplements without having blood work first! Taking any supplemental ferritin without needing it can send the entire body out of whack!

Please be careful. Don't you agree?

Jump to this post

Thank you for your concern, Merry, with which I absolutely agree. I was likely unclear in my post that the ferritin level should be checked first before taking any oral iron supplement (under a medical provider's guidance).

Part of the problem with restless legs syndrome is this: The majority of doctors do not understand RLS management and do not recognize that a low-but-normal ferritin level is not normal if you have RLS. It needs to be boosted. This is the first line approach, because medications to resolve RLS can in themselves cause problems like amplification.

Thankfully, there are medical providers at the Quality Care Centers such as Mayo who are true experts in treating RLS. The RLS Foundation website is a good place to start. Wrongly treated RLS can be a medical disaster for patients. Been there. Done that.

REPLY
1 reply
Mentor
Merry, Volunteer Mentor | @merpreb | Apr 28, 2022
In reply to @tim1028 "Thank you for your concern, Merry, with which I absolutely agree. I was likely unclear in..." + (show)
@tim1028

Thank you for your concern, Merry, with which I absolutely agree. I was likely unclear in my post that the ferritin level should be checked first before taking any oral iron supplement (under a medical provider's guidance).

Part of the problem with restless legs syndrome is this: The majority of doctors do not understand RLS management and do not recognize that a low-but-normal ferritin level is not normal if you have RLS. It needs to be boosted. This is the first line approach, because medications to resolve RLS can in themselves cause problems like amplification.

Thankfully, there are medical providers at the Quality Care Centers such as Mayo who are true experts in treating RLS. The RLS Foundation website is a good place to start. Wrongly treated RLS can be a medical disaster for patients. Been there. Done that.

Jump to this post

I understand! The neurologist picked up on mine. I was lucky. I've spent many nights awake because of those awful feelings inside of them until I learned that if I took enough ropinirole (prescribed by my dr.) and took it by 5 PM I was good. I agree that not enough medical professionals know how to treat it.

I have some blood work due soon and will look at my levels. I'm usually low and will check to see what my Neurologist says about that!

Thank you for bringing more very useful and important information to this very bothersome syndrome.

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rosa66 | @rosa66 | Jun 5, 2022
In reply to @merpreb "Rosa- It's just awful the way doctors think that your mind can bounce around so much..." + (show)
@merpreb

Rosa- It's just awful the way doctors think that your mind can bounce around so much with medication. I have felt somewhat like you. If I were you I'd go for a second opinion and get help with your anti-depressants. You don't need to live like this, nor should you. Paxil is a biggie for withdrawal symptoms, so take care. Depression is a big side effect of cancer.

My mindset is that I know that I need an antidepressant. And I'll live with it. It's all about my quality of life. When I got off of Effexor after taking it for years I knew that I needed help, that depression was part of my makeup. So that's why I thought that way.

One of the side effects of Cymbalta is sweating. And boy did I with a 90mg dose. I had taken Welbutrin for quite a while with sertraline so I just went back on that. We'll see how it works out. I have really liked Cymbalta and wished that I could tolerate the sweating. It helped me out of feeling like you do.

As far as RLS I did not like Primidone, or something similar. My tremors come on and off and I haven't figured out what is triggering it to act up. I love Ropinirole. My RLS is at night or very late in the afternoon. I hate, hate the feeling. I don't know what underlying conditions you have right now, other than cancer that might interfere with any of the drugs that you take or might try.

Where are you with cancer right now?

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I’m thinking that Primidone could be having an impact on my depression/anxiety, agitation, etc that I thought were all from Paxil withdrawal. Bi just read these can be side effects from Primidone!
Dammit! The neuro didn’t mention any of this.
How did you taper off Primidone? I’m on 50 am and 50 pm

REPLY
rjjb | @rjjb | Aug 5, 2022

Does anyone take Pramipexole for Restless Legs Syndrome?
I take it, and it helps some. Of course there is no cure for RLS,
but the Pramipexole does help me get some sleep. I've had
this RLS problem for over 30 years, and will probably die with it.
Is anyone out there trying to find a cure for RLS?

REPLY
3 replies
cmd | @cmd | Aug 6, 2022
In reply to @rjjb "Does anyone take Pramipexole for Restless Legs Syndrome? I take it, and it helps some. Of..." + (show)
@rjjb

Does anyone take Pramipexole for Restless Legs Syndrome?
I take it, and it helps some. Of course there is no cure for RLS,
but the Pramipexole does help me get some sleep. I've had
this RLS problem for over 30 years, and will probably die with it.
Is anyone out there trying to find a cure for RLS?

Jump to this post

Some homeopathic doctors recommend magnesium.

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1 reply
cmd | @cmd | Aug 6, 2022

Mirtazpine 7.5 mg is sometimes used for insomnia. Higher doses don’t appear to work for insomnia.

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rjjb | @rjjb | Aug 6, 2022
In reply to @cmd "Some homeopathic doctors recommend magnesium." + (show)
@cmd

Some homeopathic doctors recommend magnesium.

Jump to this post

I took magnesium years ago....and it didn't ease the agony of RLS one bit.

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