Restless legs syndrome (RLS) and mirtazapine
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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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?
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.
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
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!
@ess77 I'm so happy for you that Mayo gave you the procedure they did .I found info from John Hopkins that did a study on iron and RLS here,s the website http://www.hopkinsmedicine.org/RLS that talks about iron .
Hello, Vanessa. @vhn, @johnbishop, @suecreader
I overlooked mentioning something important in my message to you. The weighted blanket!
It's wonderful! It's been a big help for me, to the point that now that the weather in Florida is warming up, it keeps me, especially my legs pretty warm. So, I need the weight, not the constant warmth. What to do? The weight helps so much, with my legs and feet, cramping, back, hips and pretty much whole body. It's also good for me emotionally. The hugging it gives has helped me through the covid19 isolation as well as the normal, sometimes extreme anxiety of life. I do recommend using it, especially since you already have one and know how wonderful it can be.
Another thing to consider is your grandmother and her health. My grandfather died when I was a child with pernicious anemia. My son has extremely low B, as do I, that we must replace with strong prescription drugs. When the ferrous results showed my iron levels, they were extremely low and are only now, 2 years later while on 2 iron tablets daily, are the results in the low normal range. Still lower than we'd like, but not requiring IV replacement which was a possibility. Apparently, it takes a while for the body to adjust, but I'm better.
Since I know about my grandfather's illness, I mention it to all my doctors on first visit or if something comes up that might be related. It's important and apparently is in my case genetic. I take my supplements for several things and give myself B12 shots as well. My son takes a prescription B replacement daily that costs over $100 monthly, not insurance covered. These are keeping us both walking!
Through all this junk, all these years, I've realized this is the kind of thing most physicians don't consider, and hormones, basically some of the issues causing much of my health problems. Primary aldosteronism, again long time getting diagnosis with years of extremely low potassium, high or low blood pressure, then high sodium and thyroid went wonky. So, everything sort of got involved and now. After addressing all these things, there are many improvements in my body and life.
Blessings, Vanessa. May you have the best doctors with the most inquisitive minds ever and find the causes, not just treat the symptoms.
@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!
@ess77 I use tincture cbd every day your right it helps with the daily pain I have
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?
Good morning- I'm a mentor for the Lung Cancer and Lung health groups. I saw your post and decide to jump in. I have been depressed for ages (I'm 75 now) and have taken lots of anti-depressive meds. Right now I am taking Cymbalta and bupropion. I tried taking a larger dose of Cymbalta and no bup. but a side effect of Cymbalta is excessive sweating. Since I started sweating way too much like if I moved, I switched. It did not affect my RLS at all.
I take Ropinirole 0.5 x 4 a night. This has helped me sit still, even on long flights.
May I ask what you have taken to help calm down your restless legs?