What antidepressants suitable for RL?

[restlessstoz]

Hi there again. I've been off my SSRI now for 12 days and apart from being a bit teary and very flat and wondering what's the point of it all, I'm fine!!!! Seriously, I am coping better than I thought I would be, having been on then for over 30 years and now I'm going to the doctor to get the new ones. I just wanted to ask for advice/knowledge about which antidepressants are RL friendly? I want to be prepared incase he ends up giving me the fire after I've just ditched the frying pan!

[Hidden]

Hello!

Wellbutrin is a safe one.

Can someone help me out with the other one? Thanks!

[restlessstoz in reply to Hidden]

Thanks Sails. A good beginning and good to know that if needed, there are more.

[Hidden in reply to restlessstoz]

You’re welcome. Yep, that is true! Do you mean that you’re doing well in the RLS department? If so, that’s great!!!

I’m currently going through the books by Pema Chödrön. Have you heard of her? If not, you might be interested in what she has to say. She talks about different Buddhist practices, with the practice of Tonglen in particular. One of the pieces of advice she gives that is my personal favorite is one called “labelling”, particularly when it comes to your thoughts. I tend to over-think things and get very stressed in doing so, which is why I love this piece of advice! She advises that, whenever we catch ourselves thinking, to label it as “thinking” and not judge it. She tells us not to chastise ourselves for thinking harsh or bad thoughts, but just to label it what it is (thinking) and move on.

Anyway...could her books maybe be of interest to you? I’m only just on my second book of hers and have already learned a lot!

[restlessstoz in reply to Hidden]

This sounds a lot like the meditation practice that I'm undertaking which although isn't Buddhist, is derived from Buddhist practices. I'm working through an 8 week course and finding it very positive. I also am on the Fodmap diet and dairy and gluten free, sugar free, caffeine free... you name it and I'm trying it. The amazing thing is that even though I've gone off all the meds that supposedly stopped my RL- all prescribed by a physician and a neurologist (expert in movement disorders), my legs are no worse than when I was on them all- in fact my legs are now only problematic at night/evening, rather than 24 hours a day so I think that's definitely a winning situation. Onwards and upwards!

[Parminter]

Trazodone, Wellbutrin, Lamotrigine, Depakote, carbamazepine, oxcarbazepine -according to the Restless Legs Foundation.

[restlessstoz in reply to Parminter]

Sounds like there are quite a few to try if needed. At least if I have something to suggest then I won't be led down the wrong road, although like all RL drugs/treatment/info, it seems to be very individual. At least my GP now seems to have more understanding of the nuances of the condition than he did 6 months ago and is happy and willing to work with me to get the best outcome so will be happy to take notice of a list I can provide.

[Parminter in reply to restlessstoz]

They (the RLS Foundation) also list Nefazodone, but with the warning that it may cause iiver failure. So that one would have to be watched carefully.

[Hidden]

I believe Trazodone is another. However, I have no personal experience of it so don't know how effective it is.

Have you had, or ever thought of having psychotherapy at any time. In the last 30 years there have been developments in that area that have helped depression.

I recall that you already practice some form of mindfulness, is that right? Mindfulness CBT has, I believe been found to be effective. It has to be CBT though, not just mindfulness.

If you've been on SSRIs for 30 years your current state of mind might at least partly due to physiological and psychological withdrawal. It might be you're like someone who's been dyeing their hair for years, if they stop dyeing it, it might not be the same natural colour it was when they started.

[restlessstoz in reply to Hidden]

Thanks Manerva. Yes I have done heaps of work on 'myself' over the preceding and intervening years including psychotherapy and have come an extremely long way. I'm continuing with the mindfulness and believe it will be a great addition to my toolbox. My history with depression began as a teenager and I've lived my whole life learning to manage it. The antidepressant was/is another 'tool' that helped keep me in the right space. I wouldn't/wont resort to antidepressants unless necessary. I will discuss with my doctor his views as he supported me through 10 years of hell in the 90s following severe trauma, and with many hospitalisations.

Having been on and dumped so many drugs over the years as my mental health, 'skills' and resilience improved I certainly don't want to take another one on just for the sake of it - especially if it induces RL! I do though need to be mindful that I need to cope with a very challenging life with a child- now adult, who still battles the mental health effects of the trauma we lived through and was far more severely affected and disabled and is reliant on me to be stable and able to cope.

I would like nothing better than to drop antidepressants along with the rest of the drugs and time will tell whether I can/do. It will depend on whether I want to stay grey or keep the colour my life had on the old ones! ( ) I do appreciate the 'warning' and won't jump into another drug just because I was on one before. Thank you.

[Hidden in reply to restlessstoz]

No problem. if a little chemical help is part of your "resilience plan", not the whole thing, that's great.

I'm encouraged to see you write mental "health" not mental "illness".

[restlessstoz in reply to Hidden]

Oh yes. I'm a very old hand at the mental health talk and living the 'mental health' life. Sadly life didn't quite work out like I would have hoped and the repercussions continue. Still, I am so grateful for the little things in life that many others who haven't been through what I have, don't even see let alone appreciate. I wouldn't ever chose to live my life again or that for my children, but I'm glad that I am the person that I have become with the perspectives I have and the view of life that I have, due to having been through that life. A favourite saying I found recently is 'Gratitude turns what we have into enough.' and I have such busy, happy and good life in spite of the past and present circumstances.

Have a wonderful weekend. It's sunny here, a beautiful autumnal day which I will enjoy spending in the garden, once I had taken a short nap to make the day doable. 30 -40 minutes sleep was all I managed overnight and I do resent having to use some of this glorious day catching up, just so I don't fall over asleep all the time!

[Hidden in reply to restlessstoz]

Enjoy your day. It's supposed to be spring here, but blast of cold arctic air from the north isn't making it feel like it.

[marsha2306]

I take Wellbutrin 300 mg XL

[restlessstoz in reply to marsha2306]

I guess for depression and no effect on RL?

[marsha2306 in reply to restlessstoz]

Correct. When I first got RLS I had been taking Celexa which made it worse. Switched to the Wellbutrin which is safe. Go to RLShelp.org and scroll down to treatment. It has a list of meds ok to take.

[restlessstoz in reply to marsha2306]

Thank you so much Marsha. Will do.

[Not-methadone-addict]

Hi restlessstoz!

I see a lot of people suggesting trazodone as an antidepressant and while it can be prescribed as such it very rarely is anymore because at useful enough doses it’s generally going to make you quite sleepy and sluggish. I, for a number of years, took it at 25 mg for sleep and it worked like a charm. I also wouldn’t think many psychiatrists would prescribe Depakote for an antidepressant as it is used to treat seizures and the mania part of bipolar disorder so it is definitely not for depression. Lamotrizine is also an antiseizure and used for the mood swings of bipolar disorder. Carbamazepine is another anti seizure medication that is also used to treat neuropathy and for anxiety but has some serious side effects that are rare but that should be looked out for. Oxcarbazepine is, you guessed an anti seizure medication also used for nerve pain and bipolar disorder. In bipolar disease it is used to control the manic part of bipolar so I’m not sure this would help as an antidepressant. There a couple of new tools in our lovely arsenal to treat depression and they are GeneSight, which by taking a swab inside your cheek they can tell which antidepressant matches your DNA the best. I’ve tried Wellbutrin and unfortunately it didn’t by itself help my depression/anxiety that much. Sometimes despite the fact that an antidepressant or anxiolytics (anxiety treatment) aren’t helpful towards your RLS they can still be used and should be if it’s the only way you can get some relief. Your RLS medication may need to be increased if necessary but think of it this way. Your RLS is perfectly treated but you get no real enjoyment out of life because you’re depressed and/or anxious all the time. Where did you win? I desperately want my refractory RLS treated but at one time it was very well treated and so was my depression/anxiety on a SNRI (a serotonin and norepinephrine reuptake inhibitor) and methadone 10 mg for 13 years before our current opioid crisis. There is another weapon in the depression arsenal that is not well known but insurance is starting to pay (mine does and it’s typically crap 🙃) for it. It’s called transcranial magnetic stimulation (TMS) and is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. There are different brand names for TMS and google it for more information about how it works and whether it’s something you might want to look into. It is newer so your insurance may not cover it or it may. Always call to check no matter what the website says about how your insurance company does cover it. Recently my husband and I got almost totally screwed by a podiatrist who did surgery on my ankle that was NOT at all covered by our insurance so she decided to do it another way also not covered and we found out they were told four days before the surgery this wasn’t covered either and she did it anyway! She almost cost us $13,000 that we most definitely do not have. We were gearing up to sue her but thankfully it didn’t come to that. Moral to the story, always check with your insurance yourself. You also have to be your own advocate with your doctors. Always know what you are taking and why! Don’t blindly follow any healthcare providers directions, especially if they won’t explain it to you so you understand and won’t take any feedback from you. Contrary to some of their beliefs, they are most definitely not gods 🤨! I hope this info helps someone. You have to take the reins of your own health. Doctors, PAs, Nurse Practioner, and pharmacists are so busy now they can and are making mistakes and also don’t know you as well as you know you. Know and keep a list of every medication, supplement, vitamins and over the counter medication you take and next to it why you take it. When you are prescribed a new medication, look it up. There are websites out there that also have tools you can type in every drug, supplement, etc. you take and tell you what kind of interactions are possible. Don’t stop taking a medication until you can talk to your doctor but definitely ask them about it as soon as you can.

The above brought to you by your friendly but most definitely NOT all knowingly RN. Use google or whatever search engine you like but educate yourself about your meds, your diagnoses, treatments and really everything that is given or done to you and why. But do not trust any old site but sites like Mayo Clinic, Johns Hopkins, reliable sites. Definitely not some of these blogs by these way out there people who know nothing but what they’ve seen on Facebook or some other social media. If your doctor doesn’t like you asking questions then they are probably not the right doctor for you.

Susan Or Sus

😜

[restlessstoz in reply to Not-methadone-addict]

wow Sus, that's an impressive list of drugs and uses. I will study again when not in the throes of RL at 3 am! Thank you for taking the time to respond so thoroughly. As you say, to have RL under control but have no quality of life due to depression etc is still no life at all. I will consider very carefully my next steps and although my GP is very helpful and willing to listen to my info. I still feel as if I know more than he does. He really is trying though. unforturnately I have no health insurance so rely on the national health system which if I had cancer, would be wonderful! especially breast cancer. I'd have all the help under the sun. AS it it, it's a matter of waiting to see specialists and left to pay non-PBS drugs myself...as with the neupro patch which works spasmodically when I'm desperate enough to use one for a night's sleep! Thanks for the support. ;0

[Not-methadone-addict in reply to restlessstoz]

Any time! Unfortunately when you have more than one thing causing discomfort (in different ways but still discomfort) it becomes a balancing act to figure out treatment. Our body isn’t just a physical thing. It has mental, emotional, spiritual and so many aspects that you can’t just treat the one thing and expect everything else to just go away. Some people literally believe depression and anxiety are just “all in your head” so to speak. I could (even long before I ever tried antidepressant medication) never control my anxiety and depression just with mind things. Like I was doing cognitive behavioral therapy before I had to go off methadone and go on a medication I don’t dare drive with, and it will help me greatly but it is a tool in my arsenal and I do need to take an antidepressant unfortunately so in that part of your whole person therapy helps a lot but it isn’t enough all on its own. Some people it is if they have mild depression or anxiety but I have a major depressive and anxiety disorder and it’s genetic very strongly on my Mom’s side. I know the medication, exercise, therapy and learning to deal with stress are all important in their own way too. I’m reducing the amount I take for depression and anxiety but I don’t think they’ll ever (unless the magnetic therapy I talked about above were to make them obsolete which I’d be thrilled about) completely be eliminated. People had these disorders long before there was medication and therapy to treat them but they just stuffed these people in asylums and thought they were possessed or something. Now we don’t need to do that (or lobotomy’s or Electroshock Therapy, though this is still used much more safely) but can take something to help because we now know better. Again, I don’t believe drugs are magic and work on their own because they don’t. It needs to be a complete therapy for the whole of you. Hope that makes sense. Mostly I’m just saying it’s easy to say don’t use this medication because it’ll make your restless legs worse but Wellbutrin will not be the drug that helps every single RLS patient. Just like there isn’t a one drug option for every person with RLS. I tried Wellbutrin and it’s not what I as an individual need. It doesn’t work unfortunately. I wish it were that easy. So, sleep specialists and the whole community need to treat each person as an individual with differing medication needs. You can successfully treat both depression/anxiety and RLS. I’m living proof of that. I took Cymbalta for the depression and anxiety and only 10 mg of methadone for 13 years without needing to up my methadone. Now I know too many scary things about Cymbalta and am choosing to get off but I’ll have to seek out another drug other than Wellbutrin and taylor that AND my RLS treatment. It’s not an either or situation and some people and even the RLS community think it’s a simple answer but it’s not and since RLS is not one simple answer either they should know better. Very seldom are you just treating a person for RLS so they need to figure out how to treat the whole person as an individual and can’t assume that one size fits all. In this case not one antidepressant/anxiolytic fits all. I also really can’t believe trazodone is even considered a very realistic option because it is more often now used as a sleeping pill because it makes you tired and at a helpful dose I would think would pretty much make you more like a zombie then an alert functioning person. Ok, I’m getting off my soapbox but this has really become a pet peeve of mine because I believe we should know better than to lump all people with depression and anxiety into one treatment plan when we know you can’t do it for restless legs. We have to keep in mind with all treatments we are physical, mental, emotional, spiritual, etc beings. There is never a one size fits all for any of us no matter what we suffer from. There may not be an antidepressant option that works for you that doesn’t worsen your RLS and your doctors will have to work on that. My psychiatrist and old sleep specialist used to keep each other informed on my treatment and work together when necessary. So people who don’t have depression and/or anxiety, please stop telling people the only option is Wellbutrin or trazodone or whatever. It isn’t. Is it preferable? Yes, absolutely but it’s not the only answer and when we tell people that, it can cause a lot of harm and increase depression and anxiety. Your doctor or doctors have to work with the whole you and that might include working with each other and/or if it’s just one doctor, trying different medications and doses. It can work just please stop with the only one option or one way. We should know better and do better.

Sus or Susan