Zoloft contribute to RLS?

[tigers9]

I went to my neurologist yesterday for another consult regarding not being able to obtain Horizant. She didn't even know that it wasn't available until June at the earliest. I have been without my medication now for 1 1/2 months. She gave me a sample pack of gabapentin, but I'm a bit nervous to start it as it is only a couple of weeks worth & I don't plan on going back to her. I want to have another neurologist lined up as she completely blew me off & was condescending when I mentioned getting by serum ferritin tested. I also questioned my Zoloft for mild depression which I have been on for over 11 years. She insisted Zoloft would not affect RLS. I'm so confused. I have been doing nothing but research & running from one neurologist to neurosurgeon to neurologist to chiropractor to GP that I'm so aggravated I can't find someone to help me. I tried to get into Mayo Clinic but I live out of state with a new job so that is kind of hard! All the stuff on supplements I am trying & exercise, no caffeine, no alcohol, better diet - NOTHING HELPS ME. The last time I checked, we pay for medical service because we aren't experts & need help. I am aware this is a research process with this disease, but I don't expect doctors to not help at all!!! Everything I have read states Zoloft MAY contribute, but she was insistent that it doesn't. I am not trying to self diagnose, I just need help! Can anyone give me some advice? Does anyone know the difference between Horizant and Gabapentin (brand name Grasile)? Should I not take this new medication in case I run out before I get in to see a new doctor? Please, any advice would be greatly appreciated!

[ViewsAskew]

OK, taking off my moderator hat.....

She's not a very up to date doctor. I want to say much more but even with my mod hat off, I can't type what I want to say. And to blow you off about serum ferritin? She is an.....well, you can imagine what I was going to type.

OK, mod hat back on....

You are absolutely right - Zoloft can cause problems. It doesn't mean it is, but it can. And, there is published research to that effect. Like these:
http://www.medscape.org/viewarticle/557303_3
http://www.aafp.org/afp/2000/0701/p108. ... 01p108-b18
Or, the Triggers for Restless Legs Syndrome in the WED Foundation's Publication page: http://www.rls.org/about-rls-wed/publications

Horizant vs gabapentin is in how it's formulated. It's chemically very similar. I doubt it would hurt to try it and it might help until Horizant is back. I would try it if it were me. If it didn't work, Lyrica is another similar alternative. But, as you noted, I'd still be looking for a doctor. And, I'd likely send the old doctor research that shows that ALL SSRIs can make WED worse along with a note that she'd not soon forget .

Per doctors, we rail about this ALL the time. I had a doctor tell me, recently, that opioids can't help WED. Research shows they can and they hypothesize why. She's supposedly a sleep expert - but she didn't know and wasn't up on recent research. Finding a good doctor is like finding the Holy Grail. Shoot, I just watched a video on WED - it was a video of a talk given by two doctors to a group of family practice doctors. They had somethings wrong and many things incomplete, which could lead to incorrect things being done by the doctors. They recorded it in the last month!!!!! And had an audience of hundreds of family doctors who now don't have the right picture.

Depressing.

Especially to you at this moment! I wish I had something better to say. I've been searching for a good local doctor for almost ten years. I fly to California and pay out of pocket to see Dr Buchfurher.

[debbluebird]

You might try a sleep doc. I don't find that neuologists help much at all. Also it won't hurt to take the gabapentin, but it is a med that you wean up and have to wean down to stop it. That is also true with the horizant and lyrica. So if you have, say 100 mg of gabapentin. I'd take just one a night. Then you won't have to worry about the weaning.
Keep looking for a doc. Good luck
Oh, and yes the zoloft is probably making your WED worse.

[badnights]

But... is it worth it to take 100 mg gabapentin if the dose is too low to do anything? Certainly worth a try...

[veldon7]

My Mom takes Zoloft and it causes her to have mild RLS. I asked a Pharmacist what is the difference in Gabapentin and Horizant, and he said the only difference is that the Horizant is extended release, so it lasts longer. I am taking Gabapentin 600mg evning and night, it helps a little, but I still have to take the Mirapex, so I'm stopping the Gabapentin, it's not worth the side effects.

[badnights]

Saying Horizant is extended-release gabapentin is an over-simplification. Horizant is a pro-drug of gabapentin, which means it is converted into gabapentin (by your body) once it has been absorbed into your body. One of the big problems with gabapentin is its erratic absorption through the digestive tract, and gabapentin encarbil/ Horizant was developed partly to counteract that.

But as far as I know, once it's inside you and has become gabapentin, it should have the same effects.

tigers9, I don't recommend going back to that neurologist. Do you have a GP? Maybe the GP can prescribe for you. Has anybody recommended DAs for you ? (pramipexole/Mirapex or ropinirole/Requip, also known as the Parkinson's drugs?) If not, they might be worth a try. They are approved for WED/RLS.

As with any drug, some people get side effects. The worst side effect of DAs - only for WED/RLS patients, not Parkinson's patients - is augmentation, and the chances of augmenting are higher if you have low ferritin in your blood (also the longer you take them and the higher the dose you take). So the recommendation of specialists now is to ensure your ferritin level is over 75 ng/ml (preferably over 100) before you start on DAs, and stick to the lowest dose that stops your symptoms.

Oral iron supplements are used to raise ferritin levels; and that alone can alleviate WED/RLS symptoms, so you might want to get that checked. Check vitamin D as well; it should be over 30, and low D has been implicated in WED. Those are two things you can deal with, without prescriptions, that might have a real effect on your WED.

[tigers9]

Thank you everyone for your responses! It's so nice just to have this board where you know people "get it"! I have seen my GP who referred me to this neurologist, which makes me doubt him now as she turned out so bad! My GP admits he doesn't know a whole lot about this, so getting him to prescribe isn't going to happen - I tried. I have an appointment for Mayo Clinic in late August, which is a heck of a long time to wait, but I live in a different state. I am taking every supplement that is recommended for RLS, including iron, so I am really hoping it helps. I'm doubtful as it has been a month since I started the supplements. I still haven't started the gabapentin as I don't have another doc lined up yet & I'm afraid I won't have one in time by the time a run out of samples, it takes forever to get in anywhere out here. Beyond exasperated & ready to burst into tears from all the discomfort & aggravation - I'm sure you all can relate!

[ViewsAskew]

Some doctors are willing to learn (GPs), but many are not. I moved to Chicago about 13 years ago and loved the GP I found. She just wouldn't help me with the WED. She seemed really freaked out by it. I remember sitting in her office, showing her the Clinical Management of RLS book and that is laid it all out, and she said she wouldn't help. We'd been through at least 5 or 6 doctors and none were helping....I still feel betrayed by her!

[Polar Bear]

On the other hand, I am one of the fortunate people who, although their GP admitted to knowing nothing about WED, the GP read my info, my email responses from DR B has (so far) used this to prescribe for me.
The only negative is that he is 15 miles from me which is where I used to live, and there is a now a GP Practice 10 minute walk from our home. But I am reluctant to change to the local Practice in case they are not WED aware and even worse, do not easily accept the information and advice that I have garnered. Some new GP might even decide to reassess my medications ......

[jakesmom]

Like Polar, I also lucked into a new GP who was willing to accept the information I offered her. She is 100X more knowledgable than my former neurologist and alot more willing to listen and think outside the box when treating me. She admitted to knowing about WED and having patients who have the garden variety mild evening symptoms and readily admitted I am her first complicated case with augmentation. I am impressed by her honesty and am more than willing to be her test case. I drive 20 miles to see her. I would drive twice that for a doctor who listens and cares.

It took me a lot of trial and error to find a good doctor. It was through this site I learned that sometimes the best doctors aren't the ones who have been practicing the longest, in our case, younger docs are better because they are willing to learn and are open to suggestions.

Good luck in your search. I know it's hard to be patient, but it's worth the wait once you find a good doc.

[badnights]

Have you considered trying kratom or poppy seed tea? There are posts about these in the Non-pharma forum, but be aware, they work because they contain opioid chemicals. Opioids are, hands-down, the most effective medication for controlling RLS/WED, for most people, though their use is limited by side effects and even more by physician's unwillingness to prescribe (despite the fact that rates of addiction in WED patients are very low).

One or the other of these might tide you over til you find a doctor.

Be aware that telling said doctor what you are taking could raise inappropriate alarms in his brain and ruin the relationship before it starts.

I am not recommending these things, I have never tried them myself, and they are unregulated so no idea how much active ingredient is in each dose - or what, precisely, the active ingredient(s) is - but that said, they can be used as non-prescribed opioid medications, and opioids give relief from WED symptoms.