restless legs syndrome (RLS) and mirtazapine

Posted by rw @rwlovell, Jun 30, 2017

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.


In reply to @rwlovell I am new to Mayo Connect so hope I am doing this right. I am on .5 MG of Roprinorol at dinner & 3 MG of Ropriorol at about 8:30p.m. I still have some RLS between dinner & 8:30, but by around 10 p.m. I can't stay awake. Usually sleep until 5 a.m. or so.
Hope that might help you.

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Hi, @kittermanr – welcome to Mayo Clinic Connect. Thanks for providing some of your experience with restless legs syndrome (RLS). You are doing this absolutely right.

Before you went on this regimen of .5 mg ropinirole at dinner and 3 mg at about 8:30, what were your RLS symptoms like?


My symptoms were really bad. Hard to describe, other than I couldn't lie still & I couldn't get to sleep for hours!!! Many nights I would have to get up & walk the floor!!!


@kitterman- I feel for you. I take requip, 3 pills a night. If I get a breakthrough I'm up all night too. I never get up- I'm too tired. Do you take meds for it?


I have had restless legs for the past 25 years, and the symptoms seem to progress in terms of worsening symptoms as I get older. I've been the gamut of treatment options, and I've listened to both other people who may or may not have restless legs (some think that because they move their legs often in bed while they are sleeping that is the same as restless legs…I am of the opinion that is not restless legs since I cannot lay in bed and have to get up and walk …. a lot at night). But, I digress – to address your question about the mirtazapine, my doctor at Mayo Sleep Center said the only anti-depressant that does not exacerbate restless legs is Wellbutrin or Buproprion. I switched from Celexa, which was working in regard to depression to Wellbutrin after consulting her on my initial visit, and it did help. Another 'ah ha' moment came for me when I visited with the Fibromyalgia Department at Mayo, and they informed me that the fact that I am sensitive to so many drugs is not at all unusual. In fact, many drugs designed to relax or relief anxiety have the opposite effect for me – they increase my restless leg symptoms x 10 and sometimes for up to 36 hours. Some of those drugs are: Trazadone, Klonopin, Ativan, Compazine, etc. I hope this helps.

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