RLS and Glutamate?

[passgo]

For me, sleep deprivation leads to an increase in anxiety and a marked worsening of my OCD.

This leads to my being overtired and anxious, which then makes it even more difficult to sleep when the restlessness finally dips down to a manageable level.

For a long time, when this happened, I would take codeine tablets for a couple of days, just to break the cycle. Usually, it worked and I went back to life with restless legs that disrupted my sleep, but didn't leave me zombiefied during the days.

Gone are those days, sadly.

On Friday, I visited my doctor and explained my thinking. I just needed something that I could take that would kill off the anxiety and calm my brain so I could give my brain chemistry the best chance possible at overcoming the restlessness.

After explaining to him about how SSRI drugs are no good for people with RLS, he gave me four Lorazepam tablets to try. Half a tablet when needed (not every day).

I took half a tablet on Friday night. My mind calmed quickly and I continued reading my book for another 30 mins. Straight to sleep I went. No restless legs. Interesting.

Last night I took the same half tablet dose. It didn't work as well. Probably because my sleep hygiene was bad: I was dwelling on work stuff, didn't read my book, didn't start my mental relaxation early enough in the evening, etc. But, I did manage to get to sleep around 12:30 (as opposed to 3:30). So, it's kind of a win.

Lorazepam enhances the effects of GABA at the GABAA receptor in the brain. GABA is the yin to Glutamate's yang. Glutamate is the main excitatory and GABA the main inhibitory neurotransmitter.

A 2019 study mentioned that:

"Brain iron deficiency (BID) is considered to be a key initial pathobiological factor, based on alterations of iron acquisition by the brain, also moderated by genetic factors.

In addition to the well-known dopaminergic involvement in RLS, previous studies pointed out that BID brings also a hyperglutamatergic state that influences a dysfunctional cortico-striatal-thalamic-cortical circuit in genetically vulnerable individuals.

However, the enhancement of arousal mechanisms in RLS may also be explained by functional changes of the ascending arousal systems and by deficitary GABA-mediated inhibitory control."

So, did the GABA hike caused by the Lorazepam give my brain iron more of a fighting chance, hence my calmer legs?

I have no plans to continue taking Lorazepam. It's the Devil's work and dependence is super quick and down that road no happiness lies.

But it has encouraged me - more than before - that my brain iron is low (my blood ferritin level is on the low end). Also, I'm wondering how to decrease glutamate and increase GABA - especially at night.

Has anyone else had any experience with or read anything about the glutamate link to RLS?

Thanks.

[Hidden]

Yep, you got it. GABA is the brake and Glutamate is the accelerator. They should be balanced but if there's too little GABA or too much glutamate - wham! RLS and insomnia.

You sound as if you're aware of the role of anxiety in this and you do know at least some non-pharmacological strategies for anxiety. You might like to explore other strategies and CBT especially mindfulness CBT might be best, if you can access these.

The simplest way of reducing glutamate is to take an alpha2delta calcium channel ligand, i.e. gabapentin or pregabalin or, in the US only, gabapentin enacarbil.

These are known to be effective for RLS symptoms, relieve anxiety and promote sleep.

Here's a link to more info.

uptodate.com/contents/treat...

[passgo in reply to Hidden]

Manerva, you're a star. I'll talk to my doc about this soon.

I reckon that if I increase my iron levels and reduce my glutamate levels, my legs and mind should calm down enough for me not to feel like a really lazy zombie most of the time.

Thanks!

[Hidden in reply to passgo]

There is also some evidence that (at least some cases of RLS) "adenosine" is involved in RLS. Adenosine is another neurotransmitter that normally puts a brake on glutamate (and dopamine). The theory goes that increasing adenosine levels will decrease glutamate levels.

eurekalert.org/pub_releases...

As yet however, it appears that no agreed teratment based on this has been developed. Some people, of their own volition have tried taking, if I recall correctly, dipyridamole, a drug used for circulatory problems.

ncbi.nlm.nih.gov/pubmed/296...

As well as possibly difficult to get hold of, its probably not a good idea to self prescibe this, it has some significant risks.

[YodaDog]

The first neurologist I saw about 12 years ago said that MSG was a trigger.

[passgo in reply to YodaDog]

It certainly is for me!

[DicCarlson]

I live my life trying to assuage excess Glutamate! Ibuprofen blocks glutamate and I take it nightly (1/2 caplet when I wake up in the night). I've tried all these supplements mentioned in the article below - no real benefit for me. My severe RLS was quickly controlled with Ferrous Bisglycinate - raising Ferritin from 49 to 105 in 3 months - but Glutamate insomnia remains. So - the BID can indeed induce RLS and Glutamate excitability, and at least be caused by low Ferritin - maybe, maybe, at least in my case - I might need even higher Ferritin to control BID more and eventually lower glutamate. holistichelp.net/blog/how-t...