Has anyone tried memantine for restless legs?

[Cabaker]

I don’t have RLS, but my husband does, and I feel like it is stealing our lives. It has caused mood dysregulation and fatigue. The pramipexole he has been taking is not as effective, and I’m searching for another answer. I’m very intrigued by the glutamate hypothesis and therefore am interested in memantine and trazodone as a treatment approach.

[Ureshi17]

Hello,

I just saw there was a successful case study with someone here in Japan taking Trazodone.

academia.edu/12896464/Restl...

I'm not familiar with the other medication. It looks like something worth exploring though.

[Parminter]

Hello Cabaker. Has your husband had his ferritin levels checked? That is the best first move.

And has the pramipexole cause augmentation and worsened the situation?

One of the primary side-effects of pramipexole is insomnia, but it is mentioned quite rarely. Add to that the usual sleeplessness of RLS/WED and the hyper-glutamatergic state and you have pure misery - it is indeed a life-stealer.

The drugs you mention are quite heavy-hitters with a long list of unwanted effects. For the glutamate issue, you could attempt dipyridamole, which is an old, well-tested anti-thrombotic that is presently being used in human trials to assist with hypo-adenosinergic states. The drug is used in doses far lower than the doses for thrombosis, and it has a good safety profile. Any doctor will be familiar with it.

Have you tried opioids? They have been used for RLS/WED for centuries, and they can work magic in low doses. I would go with the drugs that are known before trying out more exotic solutions.

[Cabaker in reply to Parminter]

Parminter,

It was really kind of you to reply with such detail. We did end up beginning trazodone 150 mg, and it has definitely helped him sleep even though he still makes movements in the air with his arms from time to time while he is asleep.

I would really love to get my hands on some dipyridamole, but I have a hard time getting my provider to help us try anything new, and I don't think she would give us that. I will be graduating with my psychiatric nurse practitioner's license in August, 2019, and I need to learn what my state's restrictions are for prescribing to family members because the recent research you referenced is very exciting.

The low dose opioids for RLS is news to me and the idea is intriguing. With the opioid crisis, I am pretty darn sure his provider wouldn't go for that, and I know a controlled drug would be off the table for me to prescribe him myself.

I am also looking into supplements that modulate adenosine and/or glutamate, and I would also like him to retry gabapentin which he had attempted to take a few years back but had GI symptoms that I think could be minimized if he titrated slowly.

[Hidden]

I have been on Trazodone 150mg for depression for two weeks, this being the only anti depressant that is believed not to worsen RLS/PLMD (I have the latter). I am also on the Neupro patch 2mg which seems to be calming my legs but not helping at all with sleep.

It is early days and I am very much in the side effects zone with the Trazadone, but it hasn't had much of a positive impact on quantity or quality of sleep. What I have found is that I spend more time in the realm between sleep and wake and it feels as though a battle is taking place between the neurotransmitters in my brain, with none of them being outright winners!

I do feel that my mood has begun to stabilise on the Trazadone (less random bursting into tears) but, like many here, what will really lift my depression is getting a good night's sleep. It might be worth your husband trying is as an add on to help with mood (and possibly sleep) rather than expecting it to help his RLS.

I would also second Parminter's advice. I am interested in the dipyridamole theory, but the consultant I am seeing (like so many) isn't open to trying anything other than the standard treatments and dismisses anything else I suggest.

[Cabaker in reply to Hidden]

I believe the antidepressant Wellbutrin does not exacerbate RLS...

[Rebecca-H]

I have been prescribed Memantine for Chronic Migraine and it has made my RLS MUCH worse. I did search if this was a possible side effect of this med and yes it is. I hope this helps.