Restless Legs Syndrome (RLS) Discussion Board

I am already on Wellbutrin but I need a little more for anxiety. I stopped my Prozac a couple months ago to see if the EkD would improve. It did, but there was no way to know if it was the Prozac since I was taking massive doses of iron and Vit D at the same time (yeah I know bad experiment protocol!).

Now that I am with the kids 24/7 I find my anxiety level to be detrimental to my well-being. I am snapping over stupid stuff. I tried a couple days of the Prozac and had horrible insomnia - the worst in months.

Are there other ADs I could try? I have been on most of them at one pt or another but Prozac was the only one for which the side effects were manageable. I was probably on a relatively high dose of the others though...by the time I got to the Prozac I could get by with a minimal dose.

I would like to have energy AND patience so I can play with my kids this summer!

The good news is that the latest research shows that not as many of us are bothered by SSRIs as was thought. 10% or fewer, IIRC, were bothered.

The bad news is that there's no way to tell which one may or may not bother you....you just have to try.

Wellbutrin is the one that is usually touted as rarely if ever bothering RLS, so that would be a place to start.

I take Citalopram which does not appear to have any obvious effect on my symptoms, however my dosage is low at 10mg.

Ann ~ I am already taking Wellbutrin. It's great for general mood but not for mellowing me out.

Polar Bear ~ I think I have some Citalopram left over. IIRC, I was on 40 mg and it put me to sleep. Ironic, isn't it? Might be worth a go again at a smaller dose though.

You could try Effexor, it has anti-anxiety properties, or Klonopin, if your Dr. would give it to you, I took Trazodone before, it has calming properties, but I could only take 50 mg at bedtime, it made me drowsy. I liked the Effexor, it gave my energy but I think it was making my legs worse, so I stopped it, unfortunately. My legs are still about the same though.

I started back on 20 mg Citalopram and again I sleep like cr@p.

My psych prescribed gabapentin, since I have already tried mirapex, Ambien, and a couple benzos with no luck. I am at 200 mg, with instructions to go to 300 mg if needed. However, it doesn't seem to be helping at ALL. Does gabapentin take a while to kick in? I want to sleep NOW! Heh heh

While cleaning out the medicine cabinet, I found some hydrocodone left over from a dental procedure. Is that what some people with WED take to sleep at night? And if so, how many mgs is a "usual" dose?

So I guess two questions in one: should I be patient and keep taking the gabapentin, and which opiod is generally the one your dr starts you on, and what is a therapeutic dose?

Thanks in advance!

IIRC, you can need to take many mg of gabapenin...so I just looked at the chart in "Clinical Management of..." and it says "100-900 mg up to 3x/day"

So, you're way low of that! When I tried, I remember it taking a couple weeks to get to a useful dose (lseems like I was taking 1800 throughout the day/night, so about 600 at a time) and it still wasn't doing anything but making me groggy...I was not a happy camper!

Hydrocodone, listed in same book, is "2.5-10 mg q 4-6 hours".

In dr B's book it says that desipramine and nortriptyline might be RLS friendly too. Personally I know of 2 people that were pleased with Nortriptyline and it didn't make their RLS worse.

Corrie

Ann~ I thought gabapentin was supposed to be one of the things that worked for WED? My SIL is on 600 mg, and the pharmacist said most people are on between 300 and 900 mg so I probably have a while until I find the right dose. I'm just impatient to see if this will work, or if it's on to the next drug....

Corrie~ are those the older antidepressants? I was on imiprimine for interstitial cystitis and it initially helped my mood but that subsided and terrible side effects set in. That's actually when I started on the wellbutrin as I hadn't realized how depressed I was until I wasn't anymore, kwim? Kinda like how I don't realize how tired I am until I get some sleep! (she says optimistically hoping there will be a night with good sleep!)

Hi Tracy,

From what I understand, gabapentin seems to work best for people who have painful WED. It works less well for people with the creepy-crawly-sensation WED.

It seemed to help me for a day or two, then it wouldn't, so I'd increase the dose. That would help some for a day or two, then it wouldn't, so I'd increase the dose...etc. Squirming Susan, IIRC, had a similar experience.

There are quite a few of us here for whom gabapentin didn't work or caused side effects that weren't tolerable. I haven't any clue what percentage it helps, but it's certainly not 100 percent. Then again, almost nothing is!

ViewsAskew wrote:Hi Tracy,

From what I understand, gabapentin seems to work best for people who have painful WED. It works less well for people with the creepy-crawly-sensation WED.

True for me, a creepy-crawly sufferer. When I first started the gabapentin it worked great for the first month then stopped being effective. Increasing the dose didn't help, just made me more lethargic and sleepy.

My doc had me stop it last visit. Yay, no more daytime fuzziness at work.

desipramine is an older one if I'm not mistaken,the other one I'm not sure about.

Corrie

Both gabapentin and Lyrica help me with RLS/WED to some extent. Gapapentin is a weird drug, though, because it seems to require ever-increasing doses to remain effective. It's not quite the same as tolerance, though, because you can still stop the medication without withdrawal; it just stops working. I have taken it along with the methadone, with good results, but if I increase over three 300mg capsules a day, my hands and feet swell up. And yes, I do have painful WED at times, although it switches back and forth with the creepy-crawly variety. Gabapentin did help me sleep and it did help with PLMs.

Lyrica is a very similar drug, but seems a bit more reliable. I'm now taking that in the mornings to beat down the anxiety from the Xyrem that I take at nights to sleep. I tried gabapentin and it worked well for a few days, but that was that. I hate that Lyrica has a $40 copay and may switch back to the gabapentin just to save money. I'm on so many meds to take care of the side effects of other meds, it's just crazy.

I have taken numerous SSRIs and find that they bother my RLS for a few days when changing or starting them, but after that they don't.

Have you ever taken Buspar? It works kind of like an SSRI, but is different and doesn't generally cause worsened RLS. It's specifically for anxiety.

Be persistent. It takes all of us some time to find the medications that work for us.

I have creepy-crawly WED. I think the gaba might be helping but also not. With the gaba I don't seem to have as many minutes awake, but in the morning I wake up feeling like I have run a marathon in my sleep - my leg muscles just ache. It also seems to make it so that about 8 hours later I am rudely awakened by a painfully full bladder, which never happened before this drug.

I have taken Buspar - I might as well have been taking a sugar pill. I guess that is common - people have an all-or-nothing reaction to it.

Unfortunately, I don't seem to "adjust" to the SSRIs. I took Prozac for a couple years and the first night I stopped taking it I slept better than ever. However, I have two girls, ages 4 and 6, and if I have to choose between sh***y sleep and them having a nervous screaming angry mother, well, I'll sleep when they go to college. I just wish it didn't have to be a choice. *sigh*

Amitryptaline (sp?) can help sleep, but is linked to worsened PLM. But it does help a lot of people. I think it's good for anxiety, too. It's an older tricyclic AD. I believe it's Polar Bear who recently started that, and it's been working well. Otherwise, I'm out of ideas. But there are a lot of medications out there that can help with anxiety and sleep.

Good luck with it, and keep on trying. You want to feel good so you can enjoy your kids.