Restless Legs Syndrome (RLS) Discussion Board

At the Chicago Regional Meeting, Dr Picchietti did a presentation called, "Top Ten Things You Should Know About RLS."

10: Consider the source. In other words, if it sounds too good to be true, it is. Listen to sources you can trust such as the RLS Foundation, Mayo Clinic, etc.

9. Beware of nausea mediations. And, other mediations that worsen RLS. See a list in the Pharma sticky, order a list to carry with you (see Pharma sticky).

8. RLS And...what else? RLS and: low iron, exercise, regular sleep schedule, depression or anxiety, sleep apnea. His point was that other things can influence or affect RLS, so you need to watch those, too.

7. Got Iron? He said that dopamine agonists work best in people who have enough iron. So, have that checked FIRST! He also talked about checking your ferritin and getting it in the 80-100 range if possible, though above 50 is critical. Slow Fe may work best for people who have difficulties with ferrous sulfate.

6. There are only 2 medications for RLS???? He talked about making sure that you and your doctor know of the algorithm and using that.

5. Medications are not the be all and end all of RLS. Watch for known exacebators of RLS/PLMs: long meetings, caffeine, alcohol, nicotine, sleep deprivation, low iron stores, lack of exercise, medication.

4. Children CAN have RLS. His son, who is now 20, was one of the first children studied by Allen and Picchietti. He referred people to the RLS Foundation's guide for healthcare providers.

3. Don't be a Prozac Zombie. Try Wellbutrin first. If it doesn't work, then you have to make some decisions, but avoiding the SSRIs is a good thing if you can. He also talked about how depression and RLS were linked together and how treating the RLS first might help the depression and then to go from there.

2. Less is More. He firmly believes that we should start with small doses of things (much as Dr Buchfurer does). He talked about augmentation being more likely both with low iron stores, but with large doses.

1. Get involved! YOU can make a difference. join the Foundation. give your time. donations are important. call out those people who make fun of RLS (he called it joining the RLS anti-defamation league). help yourself, help your family, help others.

Prozac zombie? Huh? It's starting to get on my nerves that people go hysterical about being on antidepressants when the studies show that only less than 10% or so of people with RLS are bothered by them. (That study has been posted around here somewhere...) Except for Remeron, which is more like 28%. And I know so few people who can actually stand to be on Wellbutrin for the long run, and not too many for whom it even works at all.

Stepping down from the old soapbox...

You know, I wasn't sure what he meant by that. He was running late at that time and he scooted through those slides quickly. He said something about the lethargy caused by these, but I didn't get the context...

maybe we should write him and ask for a better explanation.

Oh, I also asked him if he'd be interested in being a guest on a Thursday night chat. Maybe we could ask him to review these specifically if he agrees. He said he'd think about doing it.

Yeah, I had the same reaction to the zombie line. Last year, when I switched away from Tramadol, I didn't want to give up the effect of its SNRI, so I tried Prozac for its SSRI. It caused no side effects (RLS or otherwise), despite my worry that it would, and made my life more pleasant overall.

I'm not taking very much, mind you, but it's still the case that I'm at least one person taking it and not suffering from it.

I'd have to wonder about that, too. I take Lexapro, a very small dosage most of the time, although I did increase it this past winter when it seemed that SAD was making itself part of the problem. I will try using a light box for it next winter. I have had no increase in RLS from the Lexapro and none of the side effects I got when I tried Welbutrin.