Restless Legs Syndrome (RLS) Discussion Board

I have had RLS for over 30 years and last winter I augmented on Mirapex. At my suggestion, my GP got me hydrocodone, but I came off Mirapex too fast and suffered greatly for three months. At times wondering if I could go on. I finally got in to a neurologist and she put me on Methadone 7.5mg with 900mg Gabapentin daily and dropped the hydrocodone. The hope was that if I could sleep all night, the RLS would diminish. Methadone is longer acting compared to hydrocodone. it worked. It took about a week, and I had to take the Methadone around 5pm to have it working by 10pm. One morning I woke up and looked at the clock and it was 7am, I had slept all night, no RLS. At first, I thought it was a fluke, but it has been over a month and the RLS is gone! Not lessened, it is gone! I could not believe it at first, just waiting for its horrible return. But it did not come back, not yet. I am still wary and in disbelief. Occasionally I wake up at night, but it is not because of RLS, I just wake up and eventually go back to sleep.
What did happen was worsening of depression. The neurologist is hesitant to give me anything for the depression stating that anti-depressants and opiates don't play well together. I need to do something, the quality of life some days is poor and that is an understatement. Methadone and my brain are not playing well together right now. The literature says about 50% of folks on Methadone have depression, there must be something that is compatible. Suggestions? Did I step out of one fire and into another?

Gabapentin - you are still taking it, yes? - is known to cause depressive symptoms. Methadone also can, as you noted. It is an incredible feeling when the symptoms are gone (like you, I augmented and pramipexole and eventually got to methadone, so I remember what that was like).

I know a few others here have had difficulty with either (or both) gabapentin and methadone. Hopefully they will be here shortly to share their stories.

I am surprised there was such little response to my post. Yes, I still take Gabapentin 900mg daily at the same time as I take the Methadone. Why did the Methadone work so well? There are others on this site that have taken the drug, did it not work for them? Perhaps it was when they took the drug that mattered. When I initially took the drug at bedtime, I got very little results. I had to take it long enough in advance to allow it to reach half-life before I had success. Never really considered it was not only the drug but when you took it that mattered.
With the depression issues, I have basically resolved to the fact this is my life moving forward. Wish it was different.

\
Please don't just accept the depression. It is not inevitable.

Gabapentin is more likely to be the culprit than methadone. I became suicidal on gabapentin; it is not something to be taken lightly.

The gabapentin is helping you sleep; it is wonderful for that in WED/RLS patients. So, stopping it, you might end up with fractured sleep. That's not nice, but better than depression and better than untreated WED/RLS. Every person reacts differently to medications; having complete removal of WED/RLS symptoms is unusual and must be beautiful! It is not likely to continue when you stop the gabapentin, but who knows, maybe it will! Some specialists have noticed that going for complete removal leads to increasing dosages, and they recommend going for 80-90% removal of symptoms. That can be for you to decide.

This entire board was down for over two weeks, which would help explain the low response on your post.

Please discuss the side effects of gabapentin with your doctor. From drugs.com:
- depression, irritability, or other mood or mental changes
- confusion
- drowsiness, sleepiness, or trouble with thinking
- This medicine may cause some people to be agitated, irritable, or .... feeling sad or hopeless, getting upset easily, or feeling nervous, restless, or hostile. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor right away.

I'm confused. Why are you on these drugs when your RLS has disappeared? BTW, I'm taking 3,000 mg of gabapentin daily with no depression.

Brynmr wrote: Sun May 25, 2025 11:42 am I'm confused. Why are you on these drugs when your RLS has disappeared? BTW, I'm taking 3,000 mg of gabapentin daily with no depression.

I think pexj keeps taking the medication to keep the WED/RLS away.
That's wonderful to have no depression side effects