I have finally, at least for the time being, got my RLS/PLMW under control with just the use of Neurontin, going off Mirapex & Cymbalta. Unfortunately, my depression is now off the charts and my Neurologist has said absolutely no more anti-depressants...all of which greatly exacerbate my movement.
Anyone have suggestions for 'drugless' alternatives for treatment of depression?
If I don't find something soon, I will be forced to get a Rx for the depression and risk the return of extremely severe RLS/PLMW.
Pharmaceuticals = The RLS vs. Antidepressant Dilemma
-
ViewsAskew
- Moderator
- Posts: 16580
- Joined: Thu Oct 28, 2004 6:37 am
- Location: Los Angeles
I imagine you've tried many things already. This is a very tough position for anyone who needs two classes of drugs that don't play nice together.
Some people end up with the RLS bothering them because they can't work it out. Some people find stronger RLS drugs - like opioids - to fight the effects of the ADs. I don't know how many people find non-pharma solutions. I can't think of anyone off the top of my head who has found success, but I hope that's because I'm forgetting.
Regular exercise is important to increase endorphins, which can increase your sense of well-being.
Kava-kava (not to be used in certain circumstances) can be used to lighten mood.
St John's Wort is one of the few non-pharms options that has some proven studies behind it. You are not to take it if taking some other drugs, but I don't remember the interactions.
Regular meditation can be helpful for increasing a feeling of mental well-being. Same applies to yoga, tai chi, and similar things that are done with a meditative intent.
Acupuncture and hypnosis may help.
Of course, you probably already know all of these and maybe more.
Some people end up with the RLS bothering them because they can't work it out. Some people find stronger RLS drugs - like opioids - to fight the effects of the ADs. I don't know how many people find non-pharma solutions. I can't think of anyone off the top of my head who has found success, but I hope that's because I'm forgetting.
Regular exercise is important to increase endorphins, which can increase your sense of well-being.
Kava-kava (not to be used in certain circumstances) can be used to lighten mood.
St John's Wort is one of the few non-pharms options that has some proven studies behind it. You are not to take it if taking some other drugs, but I don't remember the interactions.
Regular meditation can be helpful for increasing a feeling of mental well-being. Same applies to yoga, tai chi, and similar things that are done with a meditative intent.
Acupuncture and hypnosis may help.
Of course, you probably already know all of these and maybe more.
Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
-
ViewsAskew
- Moderator
- Posts: 16580
- Joined: Thu Oct 28, 2004 6:37 am
- Location: Los Angeles
Zach's suggestion of 5HTP - which I had forgotten - reminds me why I forgot it. It did make my RLS worse, it seemed. It's a precursor to serotonin if I remember correctly, so that could be why. Apparently in my body, more serotonin means problems with RLS.
But, as with all things RLS, that was just me....as Mark says, your mileage may vary
But, as with all things RLS, that was just me....as Mark says, your mileage may vary
Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
I don't personally recall any problems with it myself, so it could work for some people and not for others.
Personally the stuff can make you nauseous if you take even a little too much (tho the momentar peaks of euphoria were interesting) so I don't mess with the stuff anymore. Didn't do much for my mood though mileage may vary
Personally the stuff can make you nauseous if you take even a little too much (tho the momentar peaks of euphoria were interesting) so I don't mess with the stuff anymore. Didn't do much for my mood though mileage may vary
Is it not feasible to take any kind of anti-depressant at all? I thought there were a couple (wellbutrin?) that didn't generally exacerbate RLS.
Disclaimer: I often talk about what I do and what works for me, but these are specific to me and you should always consult a healthcare professional before trying these things yourself, lest you endanger your health or life.
thank you all for your suggestions!
Aiken wrote:Is it not feasible to take any kind of anti-depressant at all? I thought there were a couple (wellbutrin?) that didn't generally exacerbate RLS.
Unfortunately, I think I've tried them all, or at least one from each 'family', including wellbutrin, and all have, for some reason, exacerbated my movement. Most recently, even the smallest dose of cymbalta made my movement worse. Sadly, my depression is so severe that even the smallest dose made a difference.
I thought I read somewhere about a different kind of treatment. Not like the old shock therapy, but something using a device on the forehead. I just need to do some more research soon. But will need to wait...right now just nursing a tooth extraction
owwweee.-
ViewsAskew
- Moderator
- Posts: 16580
- Joined: Thu Oct 28, 2004 6:37 am
- Location: Los Angeles
A few years ago, after my grandfather died, my grandmother fell into a long-term depression. The next thing I knew, I was visiting her at a special section of a Chicago hospital where they treat seniors with "shock" therapy for depression.
What an amazing difference. I was a psych major many years ago in college and my idea of shock therapy was that of One Flew Over the Cuckoo's Nest. What she went through was very different and exceptionally helpful.
I don't know if they use it with other age groups, but after seeing what it did for her, I'd certainly consider it if I needed it. I'm not suggesting it's even available or that you should consider it, just that I would.
Another gentleman was here a year or so ago. He had a disorder that required him to take medication that totally worsened the RLS. Can't remember the particulars, but it was either depression or something to with dopamine antagonists. These are the exact opposite of what we take - the agonists. He was having a heck of a time finding something to help.
I hope you find something, Kimberly. Staying depressed isn't an option, I imagine. But, having miserable RLS that can make you tired and depressed, isn't an option, either.
What an amazing difference. I was a psych major many years ago in college and my idea of shock therapy was that of One Flew Over the Cuckoo's Nest. What she went through was very different and exceptionally helpful.
I don't know if they use it with other age groups, but after seeing what it did for her, I'd certainly consider it if I needed it. I'm not suggesting it's even available or that you should consider it, just that I would.
Another gentleman was here a year or so ago. He had a disorder that required him to take medication that totally worsened the RLS. Can't remember the particulars, but it was either depression or something to with dopamine antagonists. These are the exact opposite of what we take - the agonists. He was having a heck of a time finding something to help.
I hope you find something, Kimberly. Staying depressed isn't an option, I imagine. But, having miserable RLS that can make you tired and depressed, isn't an option, either.
Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
The more I think about it the more I think that this is the problem I've having right now.
I know i've bucked the trend in a LOT of instances with my medications, but i'm just wondering if the amit-yada (tri-cyclic) has reached the end of its useful life after 4 years ...
Is the Lexapro (SSRI) the right "upper" for me in the morning.
Some of the "old timer's" know a bit about the HUGE amount of stress that is being put deliberately on our family so i can't Really put all the blame on the anti-d's ... or can I?
I don't see how i can when stress (and the bloody weather lately) have been such a major factor in my daytime breakthrough symptoms.
I'm not at all keen on trying ANY DA's again so i'm stuck with benzo's and/or opiates and somewhere in there I've got to keep an eye on my thyroid.
Ok, i've managed to completely confuse myself, so i'll just go back to watching the cricket.
I know i've bucked the trend in a LOT of instances with my medications, but i'm just wondering if the amit-yada (tri-cyclic) has reached the end of its useful life after 4 years ...
Is the Lexapro (SSRI) the right "upper" for me in the morning.
Some of the "old timer's" know a bit about the HUGE amount of stress that is being put deliberately on our family so i can't Really put all the blame on the anti-d's ... or can I?
I don't see how i can when stress (and the bloody weather lately) have been such a major factor in my daytime breakthrough symptoms.
I'm not at all keen on trying ANY DA's again so i'm stuck with benzo's and/or opiates and somewhere in there I've got to keep an eye on my thyroid.
Ok, i've managed to completely confuse myself, so i'll just go back to watching the cricket.
Nadia
My philosophy is simply this: Life is too short to be diplomatic. Your friends should not care what you do, or say; and for those who are not your friends ... their loss!!!
My philosophy is simply this: Life is too short to be diplomatic. Your friends should not care what you do, or say; and for those who are not your friends ... their loss!!!
-
cornelia
Kimberly, did you try Reboxetine?
RLS and Antidepressants
Restless legs syndrome as side effect of second generation antidepressants.
Rottach K, Schaner B, Kirch M, et al. Journal of Psychiatric Research. May 2008.
Background:
There are many medications that can cause RLS as a side effect. Most of the articles published are case reports; there are few full medical studies examining this topic. When dealing with antidepressants, the literature is conflicting. The case reports published claims that RLS was caused or worsened by antidepressants. The research studies have shown that antidepressants may improve or worsen RLS symptoms. This is an important area of study because RLS occurs more frequently in patients with depression or anxiety.
Research: The researchers in this study wanted to look at “modern” antidepressants and RLS. The medications examined were fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), sertraline (Zoloft), escitalopram (Lexapro), venlafaxine (Effexor), duloxetine (Cymbalta), reboxetine (Edronax), and mirtazapine (Remeron). This study included 271 patients (aged 18-87 years), who were being started on antidepressants and who had not been on any antidepressant medication for at least three months prior. Of those participants, 227 (92%) did not have preexisting RLS while 20 (8%) had mild pre-existing RLS.
Findings included:
24 (9%) of the 271 patients either developed RLS or had worsening of RLS symptoms.
28% of the patients started on mirtazapine (Remeron) had RLS side effects.
None of the patients started on reboxetine (Edronax) had RLS side effects.
2-10% of the remaining medications had RLS side effects.
The results of this study showed that there is an association between antidepressants and RLS symptoms. Mirtazapine (Remeron) appears to have the highest incidence of side effects and reboxetine (Edronax) the lowest. It is interesting that RLS side effects appeared within the first few days of starting the medication.
The Bottom Line: Based on this study, patients need to be aware that some antidepressants may cause RLS symptoms to appear or become worse. These symptoms should appear in the first few days of starting the medication. If one antidepressant has RLS side effects, it does not mean that they all will. Some trial and error may be needed.
New Questions: What is it about these medications that cause RLS side effects? Why does mirtazapine (Remeron) appear to have a higher rate of side effects and reboxetine (Edronax) the lowest?
Corrie
RLS and Antidepressants
Restless legs syndrome as side effect of second generation antidepressants.
Rottach K, Schaner B, Kirch M, et al. Journal of Psychiatric Research. May 2008.
Background:
There are many medications that can cause RLS as a side effect. Most of the articles published are case reports; there are few full medical studies examining this topic. When dealing with antidepressants, the literature is conflicting. The case reports published claims that RLS was caused or worsened by antidepressants. The research studies have shown that antidepressants may improve or worsen RLS symptoms. This is an important area of study because RLS occurs more frequently in patients with depression or anxiety.
Research: The researchers in this study wanted to look at “modern” antidepressants and RLS. The medications examined were fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), sertraline (Zoloft), escitalopram (Lexapro), venlafaxine (Effexor), duloxetine (Cymbalta), reboxetine (Edronax), and mirtazapine (Remeron). This study included 271 patients (aged 18-87 years), who were being started on antidepressants and who had not been on any antidepressant medication for at least three months prior. Of those participants, 227 (92%) did not have preexisting RLS while 20 (8%) had mild pre-existing RLS.
Findings included:
24 (9%) of the 271 patients either developed RLS or had worsening of RLS symptoms.
28% of the patients started on mirtazapine (Remeron) had RLS side effects.
None of the patients started on reboxetine (Edronax) had RLS side effects.
2-10% of the remaining medications had RLS side effects.
The results of this study showed that there is an association between antidepressants and RLS symptoms. Mirtazapine (Remeron) appears to have the highest incidence of side effects and reboxetine (Edronax) the lowest. It is interesting that RLS side effects appeared within the first few days of starting the medication.
The Bottom Line: Based on this study, patients need to be aware that some antidepressants may cause RLS symptoms to appear or become worse. These symptoms should appear in the first few days of starting the medication. If one antidepressant has RLS side effects, it does not mean that they all will. Some trial and error may be needed.
New Questions: What is it about these medications that cause RLS side effects? Why does mirtazapine (Remeron) appear to have a higher rate of side effects and reboxetine (Edronax) the lowest?
Corrie
-
SquirmingSusan
- Posts: 3028
- Joined: Sun Nov 12, 2006 4:08 am
- Location: Minnesota
- Contact:
Hi Kimberly. There are "drugless" alternatives to antidepressants, but I'm not sure how effective they are. Here's a list of things I've tried (I'll try anything, LOL)
- omega 3s from fish oil or flax seed
- St. John's wort - interacts with EVERYTHING, but the interaction is to induce the main set of liver enzymes that breaks down other medications - so it lessens the amount of other meds in your system, if I understand this correctly. My doctor gave me an hour lecture about it.
- exercise - swimming, x-c skiing (yeah for snow!), walking, Tai Chi
- 5-htp and L-tryptophan
- Sam e
- light therapy
- Alpha Stim (for pain, but for depression and anxiety)
I'm sure there are more things that I've tried, but can't think of anything right now. Everything on my list has been "clinically proven" to help with depression, but nothing works for me except the "real" drugs. I use everything on the list anyway (except for St. John's wort and the tryptophans); wonder what my depression would be like without all that?!
Unfortunately Reboxetine isn't approved for use in the US, so unless you can get a doctor to prescribe it from overseas, it's not really an option. I've thought about asking about Strattera, which is a non-amphetamine ADD drug, and raises the levels of norepinephrine (I think) in the brain. Most ADD meds help with depression, and often help with RLS as well.
I've actually considered electroconvulsive therapy (shock therapy) and would probably go that route if I didn't tolerate antidepressants as well as I do. Nowadays it's supposed to be safe and quite effective. Scary though.
Good luck with it.
- omega 3s from fish oil or flax seed
- St. John's wort - interacts with EVERYTHING, but the interaction is to induce the main set of liver enzymes that breaks down other medications - so it lessens the amount of other meds in your system, if I understand this correctly. My doctor gave me an hour lecture about it.
- exercise - swimming, x-c skiing (yeah for snow!), walking, Tai Chi
- 5-htp and L-tryptophan
- Sam e
- light therapy
- Alpha Stim (for pain, but for depression and anxiety)
I'm sure there are more things that I've tried, but can't think of anything right now. Everything on my list has been "clinically proven" to help with depression, but nothing works for me except the "real" drugs. I use everything on the list anyway (except for St. John's wort and the tryptophans); wonder what my depression would be like without all that?!
Unfortunately Reboxetine isn't approved for use in the US, so unless you can get a doctor to prescribe it from overseas, it's not really an option. I've thought about asking about Strattera, which is a non-amphetamine ADD drug, and raises the levels of norepinephrine (I think) in the brain. Most ADD meds help with depression, and often help with RLS as well.
I've actually considered electroconvulsive therapy (shock therapy) and would probably go that route if I didn't tolerate antidepressants as well as I do. Nowadays it's supposed to be safe and quite effective. Scary though.
Good luck with it.
Susan
-
mackjergens
- Posts: 406
- Joined: Sat Jul 21, 2007 5:10 am
Ultram(tramadol)
Talk to your Dr about trying Ultram(tramadol) which is a non narcotic pain med that will usually help rls and also works like a mild antidpressant. Since you said just a little antidepressant was helpful, it could be that Ultram could help both rls and your depression.
-
SquirmingSusan
- Posts: 3028
- Joined: Sun Nov 12, 2006 4:08 am
- Location: Minnesota
- Contact:
Hey Mack ... good suggestion!
Will also take that idea to my Sleep Doc next month and maybe I can go from Three medications down to One in one hit ... that would be nice!
Will also take that idea to my Sleep Doc next month and maybe I can go from Three medications down to One in one hit ... that would be nice!
Nadia
My philosophy is simply this: Life is too short to be diplomatic. Your friends should not care what you do, or say; and for those who are not your friends ... their loss!!!
My philosophy is simply this: Life is too short to be diplomatic. Your friends should not care what you do, or say; and for those who are not your friends ... their loss!!!