RLS & depression
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lav_dance
RLS & depression
Does anyone out there suffer from RLS along with major depression who is In past, I've taken Elavil, Desyrel, and welbutrin (brand name & generic), with and without zoloft. My physician prescribed Celexa, which the pharmacist recommended not taking. A psychiatrist prescribed Neurontin to help me get to sleep, which left me groggy the following day, and Cymbalta. My reactions to Cymbalta were a nightmare. Any suggestions?
Dear LD,
If you read in the new to RLS section the listing of medications antidepressants are among those which aggravate RLS.
Here is a cut and paste job...
The following medications (dopamine-antagonist agents) may cause significant worsening of RLS in some patients.
Administer with EXTREME CAUTION:
Anti-nauseates—Benadryl, Antivert, Atarax, Bonine, Compazine, Phenergan, Thorazine, Tigan, Trilaton, Vistaril, Reglan; suggested alternatives: Anzemet, Kytril, Zofran
Anti-psychotics—Haldol, Loxitane, Mellaril, Moban, Navane, Prolixin, Risperdal, Serentil, Stelazine, Thorazine, Vesperin
Atypical Neuroleptics—approach with caution: Clozaril, Risperdal, Seroquel, Zyprexa; suggested alternative: Abilify
Anti-depressants—ALL can cause RLS worsening; possible advantage with Wellbutrin, trazodone, desipramine, Serzone, Remereon
Wellbutrin is thought to work by altering levels of the brain chemicals norepinephrine and dopamine. It is not chemically related to other antidepressants such as tricyclics (Elavil), MAO inhibitors (Nardil, Parnate), or serotonin re-uptake inhibitors (Paxil and Prozac).
The lack of restoritive sleep contributes to the depression, at least it did in my case. The frustration of not being able to sleep, then the frustration of going through the various medications till we found the right combination... etc made me very depressed. Once I was able to improve my quality of sleep the depression lessened. Actually I have long periods without depression.
Have you determined what is contributing to your RLS. Have you had your ferritin levels checked? Low iron contributes to daily overall tiredness and a sense of not feeling well, etc which can lead to depression. Has anyone prescribed a specific RLS treatment?
One the best things for me has been the support group here. It helps tremendously to know you are not alone in dealing with these issues.
Hopefully others will have some suggestions you will find helpful.
In the meantime I am holding you close to my heart and sending you many ********Positive Thoughts********** Hazel
If you read in the new to RLS section the listing of medications antidepressants are among those which aggravate RLS.
Here is a cut and paste job...
The following medications (dopamine-antagonist agents) may cause significant worsening of RLS in some patients.
Administer with EXTREME CAUTION:
Anti-nauseates—Benadryl, Antivert, Atarax, Bonine, Compazine, Phenergan, Thorazine, Tigan, Trilaton, Vistaril, Reglan; suggested alternatives: Anzemet, Kytril, Zofran
Anti-psychotics—Haldol, Loxitane, Mellaril, Moban, Navane, Prolixin, Risperdal, Serentil, Stelazine, Thorazine, Vesperin
Atypical Neuroleptics—approach with caution: Clozaril, Risperdal, Seroquel, Zyprexa; suggested alternative: Abilify
Anti-depressants—ALL can cause RLS worsening; possible advantage with Wellbutrin, trazodone, desipramine, Serzone, Remereon
Wellbutrin is thought to work by altering levels of the brain chemicals norepinephrine and dopamine. It is not chemically related to other antidepressants such as tricyclics (Elavil), MAO inhibitors (Nardil, Parnate), or serotonin re-uptake inhibitors (Paxil and Prozac).
The lack of restoritive sleep contributes to the depression, at least it did in my case. The frustration of not being able to sleep, then the frustration of going through the various medications till we found the right combination... etc made me very depressed. Once I was able to improve my quality of sleep the depression lessened. Actually I have long periods without depression.
Have you determined what is contributing to your RLS. Have you had your ferritin levels checked? Low iron contributes to daily overall tiredness and a sense of not feeling well, etc which can lead to depression. Has anyone prescribed a specific RLS treatment?
One the best things for me has been the support group here. It helps tremendously to know you are not alone in dealing with these issues.
Hopefully others will have some suggestions you will find helpful.
In the meantime I am holding you close to my heart and sending you many ********Positive Thoughts********** Hazel
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation.
Music can be made anywhere, is invisible and does not smell. --W H Auden
Music can be made anywhere, is invisible and does not smell. --W H Auden
Hi LD-
I also have depression- I think it's fairly common with those of us with chronic health conditions like RLS. (Plus, depression has been closely linked with lack of sleep which pretty much describes all of us here). I have been on celexa for almost 6 years now and have found it to be a very, very good drug for depression. It does, however, worsen my RLS- so I've had to be pretty aggressive with my meds to treat my RLS. Wellbutrin is supposed to be the best choice for those of us due to it's dopaminergic properties but I've had more failures with my patients on this medication for depression then with the SSRIs (prozac, paxil, zoloft, celexa, lexapro). Zoloft tends to be stimulatory and can sometimes worsen insomnia so that's probably not a good choice for us. Paxil has a very short half-life which can mean significant withdrawal symptoms so I try to avoid that drug as well. As a pharmacist, I can understand why your pharmacist told you to avoid celexa as he/she probably didn't want to worsen your RLS. To play devil's advocate, I would argue that depression significantly worsens your RLS and should be approached with just as much intensity. My advice (and take that for what's it's worth since I'm NOT a doctor) would be to try the celexa but at a low dose of 10 mg and see if it 1) worsens your RLS significantly- if it does, you can either quit the drug OR do what I did and accept that you have to treat your RLS more aggressively, and 2) see if it even helps your depression. Be aware it can take up to 6 weeks for some to see results (which may be more visible as you escalate your celexa dose). As for your sleepiness response to Neurontin- this is VERY common with that entire category of drugs. I am on neurontin and can tell you that the sleepiness you describe DOES get better with time. I think I was back to "normal" within a few weeks after starting. It's just something you have to put up with for a short period of time. Starting at a low dose can help with the side-effects(100 mg). Did you find that it helped your RLS?
I also have depression- I think it's fairly common with those of us with chronic health conditions like RLS. (Plus, depression has been closely linked with lack of sleep which pretty much describes all of us here). I have been on celexa for almost 6 years now and have found it to be a very, very good drug for depression. It does, however, worsen my RLS- so I've had to be pretty aggressive with my meds to treat my RLS. Wellbutrin is supposed to be the best choice for those of us due to it's dopaminergic properties but I've had more failures with my patients on this medication for depression then with the SSRIs (prozac, paxil, zoloft, celexa, lexapro). Zoloft tends to be stimulatory and can sometimes worsen insomnia so that's probably not a good choice for us. Paxil has a very short half-life which can mean significant withdrawal symptoms so I try to avoid that drug as well. As a pharmacist, I can understand why your pharmacist told you to avoid celexa as he/she probably didn't want to worsen your RLS. To play devil's advocate, I would argue that depression significantly worsens your RLS and should be approached with just as much intensity. My advice (and take that for what's it's worth since I'm NOT a doctor) would be to try the celexa but at a low dose of 10 mg and see if it 1) worsens your RLS significantly- if it does, you can either quit the drug OR do what I did and accept that you have to treat your RLS more aggressively, and 2) see if it even helps your depression. Be aware it can take up to 6 weeks for some to see results (which may be more visible as you escalate your celexa dose). As for your sleepiness response to Neurontin- this is VERY common with that entire category of drugs. I am on neurontin and can tell you that the sleepiness you describe DOES get better with time. I think I was back to "normal" within a few weeks after starting. It's just something you have to put up with for a short period of time. Starting at a low dose can help with the side-effects(100 mg). Did you find that it helped your RLS?
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KristinW
Celexa
Thanks everyone for your input. I too am on Celexa, which has worked fine for depression. however it did aggravate the RLS. I recently began Klonopin to help with sleep and RLS. It indeed made me sleepy which is good, as I was a night owl in the truest sense before.
NOW, however, I find that depression symptoms are starting up as if I never was on an SSRI at all. I am perplexed and dismayed and am trying to be open, pray, and (here) ask for any one's wisdom. I hate being on meds period!
Many thanks to all who share.
NOW, however, I find that depression symptoms are starting up as if I never was on an SSRI at all. I am perplexed and dismayed and am trying to be open, pray, and (here) ask for any one's wisdom. I hate being on meds period!
Many thanks to all who share.
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KristinW
klonopin etc.
Thanks MMCoffee! I should add that, on top of all this, I am perimenopausal or almost in menopause. People tell me that alone can cause "depression." That and PMS I guess. (Sorry all you guys who have to read this.)
Again, thanks to all who share.
KW
Again, thanks to all who share.
KW
Hi you all. I too have experienced a mild form of depression since puberty. I never thought about my sadness,irritability, or occasional lack of the ability to feel any emotion at all...I thought it was just my "personality". I've had RLS most of my life, also, but I never gave IT much thought until the last 5 years, when it seemed to be taken more seriously by the general population. I've taken most anti-depressants currently available, and, with the exception of Wellbutrin and Trazodone, they all made my legs go nuts. They all helped my depression, but ruined my sleep, and my ability to sit in my car, at home in a chair, or at my desk at work. I've been taking .5-1.25mg of Klonopin divided into two doses each day for the past 2-1/2 years. Originally I took it to enable me to get through the days without panic attacks. Lately I realize that I don't worry as much about things, sleep better, and generally feel better too. Concerns about addiction and tolerance to Klonopin caused me to recently attempt tapering off of the medication, but the first thing that I noticed was a great increase of RLS symptoms. So, with my doctors' help, I'll try to control the RLS with Requip or Mirapex, and then try to SLOWLY taper of the Klonopin. If I find that I need the clonazepam to feel better and sleep better, then I'll keep taking it. For those of us who suffer from depression and RLS, I think we need to hang in there, and never give up the search for the combination of nutrition, exercise, and/or medication that will work to make our lives better, more productive, and joyful. Best wishes to you all, and thanks for being here. ---Andy [/b]
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Rubyslipper
- Posts: 992
- Joined: Wed Mar 24, 2004 2:53 am
- Location: Missouri
Andy is right, we never give up for if we don't fight against this, who will? Most people don't think that RLS even exists, so all the baggage that goes with RLS is made up also. We know better. We have to help educate ourselves and others in this fight. On other posts I have expressed the importance of contributing to the RLS Foundation with whatever money you can afford to send. They are extremely dedicated to finding a cure and researching medications. I have sat in on two Board of Director meetings and KNOW how hard they are working for us. I am not on the Board so I can urge you all to contrubute what you can for research to the Foundation. The money is well looked after. This is OUR Foundation, the one that is looking after us. We have to do what we can to support them and each other. Depression hits almost everyone of us at one time or another. RLS makes it worse. Wellbutrin works for me, but it isn't for everyone. Klonopin works the same way for me as it does for you Andy, but when I tried going off it, I was miserable. So for now I'm staying on it. We're all here for each other and it does help to talk it out with others who understand. Keep posting, we'll keep reading a responding.
You've always had the power my dear, you just had to learn it for yourself! (Glinda of Oz)
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scootermom
- Posts: 13
- Joined: Fri Jul 07, 2006 12:27 am
- Location: Las Vegas
- Contact:
Drugs
I have POTS as well as RLS. For the POTS I take both Celexa and Wellbutrin. My cardiologist says it is the Celexa that is worsening my RLS, but does not want to take me off of it. I just figures out the RLS about 2 weeks ago, but I know that I have had it forever. I'm now on Requip and the nausea has now gotten to me.
Ya know it is always sumtin!
I just figure I gotta do whatever it is that I gotta do to get by and have a life.
Thanks to all for being here. I'm very happy to have found a new home where people understand!
Ya know it is always sumtin!
I just figure I gotta do whatever it is that I gotta do to get by and have a life.
Thanks to all for being here. I'm very happy to have found a new home where people understand!
Well, the Klonopin tapering idea didn't work out really well...the muscles in my legs started tensing up, insomnia got worse. So I'll stay on it as long as I need it. My mood is skidding into the dumpster too...I can't seem to make decisions regarding what to do about this RLS/PLMS thing, and I feel trapped in a job that is truly unrewarding and with a terrible commute to and from. I can tell when my mood is deteriorating...indecision, fear of change, irritability and a general feeling of hopelessness for the future...all of these increase. I've got to get on an antidepressant. I'll try Wellbutrin. Physical exercise sufficient to elevate my mood unfortunately also elevates my symptoms of RLS/PLMS. Mirapex and Requip, even at small starting doses, destroy whatever sleep I'm able to get with the Klonopin and Neurontin, and these drugs also seem to increase the muscular tension in my legs which aggravates the sciatic nerve in my right butt. (One of my neurologists jokes that this RLS/Sciatic stuff is a pain in the a--.) I really appreciate doctors' humor when I'm the one with the topic of their jokes! I saw a sleep doctor, who is very conservative with prescribing medications, and told me that "insomnia really isn't a serious problem"! I was tempted to ask him then specifically what IS his purpose as a sleep MD? Oh well, enough of my ramblings. Hope you're all hanging in there, and on the mend. --Andy
Dear Andy,
Cannot offer much more than my heartfelt support and send you many *************Postive thoughts of Energy***************
RLS truly is a frustrating illness, doesn't help to have all the other things going on either and what an idjet the dr is to say insomnia is not serious. Don't often wish bad things on others, yet it would certainly be justifiable for the dr to experience a good bout of insomnia, maybe his empathy would be heightened.
Keeping you in my thoughts and prayers, Hazel
Cannot offer much more than my heartfelt support and send you many *************Postive thoughts of Energy***************
RLS truly is a frustrating illness, doesn't help to have all the other things going on either and what an idjet the dr is to say insomnia is not serious. Don't often wish bad things on others, yet it would certainly be justifiable for the dr to experience a good bout of insomnia, maybe his empathy would be heightened.
Keeping you in my thoughts and prayers, Hazel
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation.
Music can be made anywhere, is invisible and does not smell. --W H Auden
Music can be made anywhere, is invisible and does not smell. --W H Auden
I take Wellbutrin for depression; it's an atypical antidepressant and doesn't give me a problem with my RLS. I also take Klonopin for the RLS so they seem to work well. I also take Lexapro which I believe is an SSRI type of antidepressant. Doesn't that all sound confusing? But if it ain't broke don't fix it!
Jenny
Hi Jenny,
It's funny how some medications work for some and not for others, and how these medications will be problematic with adverse effects for some people, and for others, no problems at all. My brother with major depression can take the most energizing of antidepressants and they make him sleepy, while if I take these same meds, I'm up all night like an owl. I'm happy to hear that the wellbutrin and Lexapro combination work well for you, and I agree that "if it ain't broke, don't fix it". Has anybody here been on Klonopin for more than a year or two, and does it still work for their RLS with insomnia? I've been wondering if I might increase the dosage at night from the .75mg I'm currently taking. I'm wondering if it's reasonable to ask my MD to prescribe the higher dose. The psychiatrist who originally prescribed .5mg twice a day for panic attacks in the past wouldn't increase the dose. I have never had an addiction problem with these medications, and have in the past thrown away outdated benzodiazepines. Since I have discovered that the clonazepam helps with the insomnia/RLS, I want to ask for a larger quantity, but I fear that the MD might view this as drug-seeking behavior for a controlled substance. Oh well, I guess the worst that can happen is he'll say no. I hope you all are having a great day. --Andy
It's funny how some medications work for some and not for others, and how these medications will be problematic with adverse effects for some people, and for others, no problems at all. My brother with major depression can take the most energizing of antidepressants and they make him sleepy, while if I take these same meds, I'm up all night like an owl. I'm happy to hear that the wellbutrin and Lexapro combination work well for you, and I agree that "if it ain't broke, don't fix it". Has anybody here been on Klonopin for more than a year or two, and does it still work for their RLS with insomnia? I've been wondering if I might increase the dosage at night from the .75mg I'm currently taking. I'm wondering if it's reasonable to ask my MD to prescribe the higher dose. The psychiatrist who originally prescribed .5mg twice a day for panic attacks in the past wouldn't increase the dose. I have never had an addiction problem with these medications, and have in the past thrown away outdated benzodiazepines. Since I have discovered that the clonazepam helps with the insomnia/RLS, I want to ask for a larger quantity, but I fear that the MD might view this as drug-seeking behavior for a controlled substance. Oh well, I guess the worst that can happen is he'll say no. I hope you all are having a great day. --Andy
I know this is a late post but, being somewhat new, I'm just looking for the right spot to fit in a question, or if I might be helpful, a response.
I had been on Klonopin for about two years and got up to 1.5 mg. at bedtime. Discontinued use as it became ineffective. I titrated off slowly...about 1/4 mg. per week and did not experience major difficulties.
Regarding anti-depressants, as this may be in my future but for anxiety...if the med jacks up the rls symptoms does this decrease back to "normal" levels once the anti-depressant has been stopped or does the increase in symptoms linger.
Thanks to this board I am aware of the recommended short list of anti-depressants but understand the variable results even with those thought to have a better chance of not exacerbating rls. I understand that Elavil is not on that short list and that others have had both good and bad experiences it. I would be interested in hearing of any more good experiences as this is one that has been suggested to me for possible consideration--once by a major university sleep disorder clinic and again for anxiety related to concerns. Need to do more research into this.
Shalom
I had been on Klonopin for about two years and got up to 1.5 mg. at bedtime. Discontinued use as it became ineffective. I titrated off slowly...about 1/4 mg. per week and did not experience major difficulties.
Regarding anti-depressants, as this may be in my future but for anxiety...if the med jacks up the rls symptoms does this decrease back to "normal" levels once the anti-depressant has been stopped or does the increase in symptoms linger.
Thanks to this board I am aware of the recommended short list of anti-depressants but understand the variable results even with those thought to have a better chance of not exacerbating rls. I understand that Elavil is not on that short list and that others have had both good and bad experiences it. I would be interested in hearing of any more good experiences as this is one that has been suggested to me for possible consideration--once by a major university sleep disorder clinic and again for anxiety related to concerns. Need to do more research into this.
Shalom