Saying hello! - driven to distraction

[Danthespan]

Hi I am new to the group
I have RLS and it is driving me to distraction, Dr said there is no cure and have to live with it. I am taking Mirtazapine and think it might be making it worse.
Im like a zombie through the day at my wits end

[stjohnh]

Hi I am new to the group
I have RLS and it is driving me to distraction, Dr said there is no cure and have to live with it. I am taking Mirtazapine and think it might be making it worse.
Im like a zombie through the day at my wits end

Hi Danthespan and welcome to the group. Lots of helpful people here and you can learn a lot and almost certainly improve your situation.

Your doctor is correct in that there is no cure. It is primarily a genetic disease affecting iron metabolism. However, your doc is not correct when he says "you just have to live with it." There are several effective treatments, though (except for iron) they do have significant side effects.

That said, there is a problem with the mirtazepine. It is an antidepressant with strong antihistamine effects. Antihistamines make RLS worse. Your symptoms are likely much worse due to the mirtazepine. You need to see your doctor and get a different antidepressant. Cymbalta (duloxetine) seems to be an antidepressant that doesn't seem to make RLS worse. You may find you don't need any treatment for the RLS after you get off the mirtazepine.

RLS is caused by BID (Brain Iron Deficiency). Many people with RLS can have their symptoms markedly reduced or even eliminated with IV Iron treatments. This is the only treatment that gets at the basis for RLS (low brain iron). It has almost no side effects. The International Restless Legs Syndrome Study Group has elevated IV Iron treatment to first line therapy. This means that IV Iron is one of the first treatments doctors should try, not one of the last (as has been done for many years). If you can get your doc to prescribe IV Iron treatment (assuming you still have symptoms after getting off the mirtazepine), that is the way you should go. Unfortunately this is fairly new information and most docs, even those that frequently treat RLS, are not aware of it. Note that the blood test doctors usually do to check for low iron (ferritin test) only checks for low BLOOD iron, there is no test available for checking for low BRAIN iron. Oral iron usually doesn't provide a high enough blood level increase to help, folks need IV Iron infusions. Here is a link to the guidelines:
https://www.sciencedirect.com/science/a ... via%3Dihub

[Rustsmith]

Dantespan, in addition to what Holland has said, there is a question about why you are taking the mirtazepine in the first place. If you are taking it to treat depression, then replacing it with a different antidepresseant, such as Cymbalta or Wellbutrin, may significantly improve your RLS symptoms since antidepressants as a class of meds also can either cause RLS symptoms or make RLS much worse.

However, if you doctor prescribed the mirtazepine to help with insomnia and not depresssion, then you definitely need to get your doctor to switch you to a different class of medications. Gabapentin and Lyrica are often used to treat RLS (after treating for iron as Holland described) and they can also help with insomnia, which can actually be the symptom of RLS that most frequently sends patients to doctors looking for treatment.