Restless Legs Syndrome (RLS) Discussion Board

I've had PLMD for about 5 years now, in the form of my feet twitching all night long. So far, nothing has made any difference, I've tried various meds, tweaking my diet etc. However, for some reason, alcohol actually gives me temporary relief of symptoms. For about 1 hour after having a beer, the foot twitching magically stops.

Which, of course, has me wondering... WHY ? What is alcohol doing to STOP my foot twitching?

From what I've read, alcohol will....

1) Temporarily increase ferritin levels - My last reading a year ago was 93, so my ferritin seems to be fine.

2) Increase Serotonin - not sure how this might interact with other systems in the body.

3) Increase Dopamine - Perhaps this might be the reason? I did try a dopamine agonist for a few days but discontinued after no results/more daytime fatigue.

From just about every post I've read regarding the consumption of alcohol, my results are the exact opposite of everyone else.

Anyone have any other ideas?

Nobody will know for sure. We can all only speculate to why this is the case. I would also assume that higher doses of alcohol would worsen your symptoms.

Alcohol does stimulate GABAnergic pathways, similar to the way benzodiazepines like Diazepam (Valium) or Clonazepam (Klonopin) do. Alcohol is basically a hypnotic (from a pharmaceutical point of view and the way it works in your brain) and hypnotics can have short term benefits on such symptoms.

For me personally, alcohol always triggered symptoms, mostly when the effects from alcohol were off but I am also very sensitive and don't even tolerate caffeine or chocolate anymore.

You can look up how drugs like Propofol or barbiturates work. They are all in the same meta-group of GABAnergic substances, just like benzodiazepines and alcohol. If you want some in-depth answers, I think this is where you might find them.

thesleepless1 wrote: 3) Increase Dopamine - Perhaps this might be the reason? I did try a dopamine agonist for a few days but discontinued after no results/more daytime fatigue.

Most things that increase dopamine can help RLS. Smoking, kratom, and that's how opioids supposedly work for RLS, by increasing dopamine.
Alcohol is often the one exception, the neurotoxicity of ethanol appears to exacarbate RLS for most people, offsetting the dopamine effect.

It's a common theme, things that help some people make other people worse, and it makes no difference for the rest. I guess alcohol is no exception in this respect.

For me, alcohol doesn't seem to do anything.

thanks for the replies.

thesleepless1,
this is a very unscientific response compared to the other thoughtful responses you’ve received so far...I’m curious, do you think that anxiety contributes to your awareness of your PLMD? In my case it truly does. I’ve spent years trying to lessen my chronic anxiety through different means. I haven’t had alcohol since forever but I imagine a beer before bed would calm my anxiety substantially. I’ve actually been wanting to test this but haven’t gotten around to it yet.

yawny wrote: ↑

Tue Aug 04, 2020 1:06 am

thesleepless1,
this is a very unscientific response compared to the other thoughtful responses you’ve received so far...I’m curious, do you think that anxiety contributes to your awareness of your PLMD? In my case it truly does. I’ve spent years trying to lessen my chronic anxiety through different means. I haven’t had alcohol since forever but I imagine a beer before bed would calm my anxiety substantially. I’ve actually been wanting to test this but haven’t gotten around to it yet.

I think periods of heightened stress/anxiety does exacerbate the severity of my PLMD. Perhaps the alcohol plays a part in this respect.

Frunobulax wrote:that's how opioids supposedly work for RLS, by increasing dopamine

The manner in which opioids relieve WED/RLS is not known. Opioids tend to reduce neuron excitability; that's also potentially a mechanism by which WED/RLS symptoms are improved (WED/RLS sensory abnormalities are thought to be un-inhibited neuron noise).

thesleepless1,
I have PLMD, like you. I’ve found that my symptoms scale with my anxiety and have recently been experimenting around Gaba. Like QyX mentioned, you may be working on your gaba receptors. “Alcohol mimics gamma-aminobutyric acic (GABA), the major inhibitory neurotransmitter in the brain.” I’ve tried straight Gaba without results. When I take Gaba influencing herbs, along with my low dose medications, I sleep more soundly. Simply put, I don’t notice my PLMD twitching. What I’m finding interesting is that the herbs all affect me differently. Maybe some are stronger than others, or maybe they simply work somewhat differently. I had been using Valerian and it got me about 4 hours of sleep, but I recently tried American Skullcap and it’s been very successful with 8-10 hours. And this while titrating off of Gabapentin (don’t think it works & makes me next day groggy). I take the herbs 2 hours before bedtime. After some research, I just ordered a bunch of other Gaba influencing herbs to try. I’m looking forward to trying Hops. If you google Gaba herbs, you’ll get a good list of ones to try. Always check for medication contraindications.

I take 3000 mg of gabapentin daily. A couple shots of bourbon late at night helps my symptoms so much that (on occasion) I'll forget to take the remaining 600 to 1200 mg.

Brynmr wrote: ↑

Mon Apr 04, 2022 8:54 pm

I take 3000 mg of gabapentin daily. A couple shots of bourbon late at night helps my symptoms so much that (on occasion) I'll forget to take the remaining 600 to 1200 mg.

wow interesting

Please be aware that the "gaba" prefix in gabapentin has nothing to so with GABA, the receptors that benzodiazapines work on. Gabapentin does not act on GABA receptors. sorry, I don't have any references at my fingertips, but you can look it up. FWIW (not much I'm afraid), I'm an MD (a dirty word on this forum lol)..

Speaking of anxiety and PLMD, I have observed that I can have involuntary twitching and jerking in the absence of any anxiety; but if an anxious thought or trigger arises i can have a much more violent "spasm", sometimes involving my diaphragm and causing me to expel air or grunt. I definitely notice anxiety exacerbates my movement disorder and I sometimes wonder, "could this whole thing just be anxiety?" I don't think so. I might experiment with clonazepam to see if will improve or worsen symptoms. anyone else with observations regarding anxiety and RLS/PLMD?

badnights wrote: ↑

Wed Sep 02, 2020 5:27 am

Frunobulax wrote:that's how opioids supposedly work for RLS, by increasing dopamine

The manner in which opioids relieve WED/RLS is not known. Opioids tend to reduce neuron excitability; that's also potentially a mechanism by which WED/RLS symptoms are improved (WED/RLS sensory abnormalities are thought to be un-inhibited neuron noise).

I believe the main mechanism by which opioids work is increasing endorphins, which work downstream to increase dopamine.

FWIW (not much I'm afraid), I'm an MD (a dirty word on this forum lol)..

Not a dirty word! Though I do wish more MDs had the disease . As in every profession, some MDs are good, some are bad, some are neutral, and all have good days, bad days, and in-between days. I hope our common rants about doctors who don't get it aren't ever construed to mean "no doctor gets it" or worse, that no one here likes doctors.

I might experiment with clonazepam to see if will improve or worsen symptoms. anyone else with observations regarding anxiety and RLS/PLMD?

You probably know this, but clonazepam used to be one of the main medications prescribed for WED/RLS before dopamine agonists came on the scene. For some people (eg. stainless who is a member here), clonazepam worked for years to get rid of WED/RLS symptoms. But for many others (myself included), clonazepam didn't treat the WED/RLS & therefore turned me into a zombie. Whether it's the anxiety treatment that helps the WED/RLS, or something else, it's worth the experiment to see if it does help you. (I have mild to moderate anxiety, which the clonazepam didn't seem to affect. But I didn't give it much of a try.)