As depressions result from a Dopamin problem in the brain and RLS seems to be a Dopamin problem of the brain as well, here my questions:
1. Did you suffer of depressions before you've got RLS?
2. If so, did you take Antidepressants over a long period of time?
Why do you want to know? Are you suffering from depression? As a result of your RLS maybe? Or do you take anti-depressants and have they caused you RLS?
I wonder if a long term use of antidepressants may cause the permanent form of RLS.
Good hypothesis! Antidepressants are known for 'causing' RLS. Whether the RLS becomes permanent is not known. No studies, few of any consistent stories.
If you're asking if RLS can cause depression, then the answer is YES.
However, I'm mo entirely sure that there is a direct physiological connection, i.e. dopamine.
Depression may possibly have some link with low dopamine levels in particuar parts of the brain, but a) RLS is a associated with dopamine dysfunction in OTHER parst of he brain and b) Dopamine levels in RLS are NOT low.
Conversely, as Lotte says many antidepressants i.e. Tricyclic, SSRI and Serotonin Epinephrine Reuptake Inhibitors can cause RLS.
It's never a good idea to take an antidepressant for any length of time for any reason.
It's usually better to deal with the issues that underlie the depression.
If this is RLS then this means controlling symptoms as best you can and finding strategies for coping with the symptoms that aren't controlled, as best you can.
There are 2 forms of depressions:
1. depressions caused by problems in your life => antidepressants won't help, you need a psychotherapy
2. depressions caused by a malfunction of the brain => a psychotherapy won't help, you need antidipressants.
I know that antidepressants can cause RLS as a side effect i.e. Seroquel causes a severe RLS attack as soon as I take it. My question is if a long term use of antidepressants will cause RLS to be permanent maybe because they damage the brain?
My second question would be if there maybe is a connection between depressions caused by a malfunction of the brain and RLS.
I believe that a distinction used to be made between "reactive" depression and "endogenous" depression i.e. not associated with any event.
These are the two types you refer to.
The labels "neurotic" and "psychotic" were also used for the two. Additionalky, acute or chronic.
It was one theory that endogenous depression was "caused" by some sort of biochemical imbalance, but there isn't, I believe any real evidence for this. The theory arose from the fact that chemical substsnces can relieve the symptoms.
Any biochemical difference found in somebody with "endogenous" depression can be explained as a result of depression, not as a cause.
I think more recently no such distinction is made. Depression is mild, moderate or severe. Each case is considered on it's own particular features.
It has been found that antidepressants are effective for mild or moderate depression but NOT for severe depression.
In depression that's due to a life event talking therapies such as counselling can help.
It has been found that Cognitive Behaviour Therapy can be quite helpful with more chronic depression, i.e. that used to be thought of as endogenous. Mindfulness CBT, a more recent variant is proving to be also more effective, in the long term, than drugs.
Not every case of chronic/endogenous depression responds to CBT but it's difficult to say how many can be helped by it because doctors and sufferers tend to prefer the easier option of taking drugs. I appreciate that when you're depressed it is difficult to see a way out of it.
However, the majority of people taking antidepressants long term are probably taking them unnecessarily.
If the drugs are also causing other issues, e.g. RLS, which itself can cause further depression, it seens sensible to seek a non pharmacological therapy.
Later
The latest version of the Internation Classification of Disorders ICD-11 does not make a distinction between the two types of depression you mention.
It identifies the following classifications
Single episode depressive disorder
Recurrent depressive disorder
Dysthymic disorder
Mixed depressive and anxiety disorder
Bipolar disorder, which may have a physiological basis is a separate issue.
In answer to your first question, I can say from personal experience that even short term use of an anitdepressant can lead to a prolonged increased severity of RLS despite the cessation of the antidepressant. However this appears to depend on two things. One is how the RLS is treated and the other is how reversible are any changes the antidpressant causes.
Again, from my own expereince only. I can say that if the increased severity in RLS is not recognised as being a result of the antidperessant or if this is ignored and the RLS is treated with a dopamine agonist, this in itself will apparently prolong the severity of the RLS because of dependency on the agonist. and subsequently augmentation. I believe that there's also some evidence that agonists can make permanent changes to the brain.
In the case of antidpressants however, I believe any changes it makes to the brain may be reversible. Obviously, the longer the antidpressant is used the less reversible any changes might be. Another reason for not using them long term.
In answer to your second question, again since there's no real evidence of a brain dysfunction causing depression then there's probably no connection with RLS. Your question implies that depression causes RLS (or they have a common cause). It's more probably the other way round i.e. RLS causes depression.
It's also a bit more complicated than that, because there is a variety of factors leading to "depression" which in itself has many forms, i.e. it's not a singular condition. RLS and depression may also be coincidental i.e. someone may have both at the same time, but others may still be deperessed even if they don't have RLS and someone else may be depressed but not have RLS.
Serotonin is the neurotransmitter closely associated with depression, dopamine is linked to addiction and impulse disorders.
I'd imagine many suffering long term with RLS would on occasions become depressed, unfortunately the 'easy' solution of antidepressants never fixes it.
Yes to both questions
Hi
I did suffer with depression before I suffered with RLS.
In 2006 I started to be widened off Diazepam/Valium which I’d been on for a bit 20 years.
It took about 7 months to get off them completely but almost straight away the RLS started. I was told that it would go away after a while. It took my GP 5 years yo then diagnose me with RLS and put me on Ropinarole.
RLS has ruined my life! I would have preferred to have stayed on the Valium for the rest of my life but the experts seemingly know better🤔.
Thanks
Sean
My experience after suffering of depressions for 40 years is that RLS is worse. Never thought I would say that. There is really an illness worse than depressions.
Hi Sean,
Valium has not been considered as an effective treatment for depression for many years. It's also not an effective treatment for RLS.
It's difficult to actually say that your RLS was caused by withdrawing from valium, it's possible but unlikely. It will probably be coincidental. If your RLS is currently severe and affecting your quality of life, then starting on valium again may have little effect.
There are many other thkings that can be done to manage RLS symptoms, I hope you are aware of them.
I started on antidepressants over 10 years ago and my RLS began two years ago, I stopped taking my antidepressants and it took about three months before my RLS disappeared but unfortunately my depression Out-weighed the RLS so I returned to my antidepressants and my RLS returned, so the questionnaires are you able to deal with your depression if so then do so but if you can’t then you must except the RLS and have the depression dealt with. My depression cannot be dealt with outside of medication as I have neurosis and no amount of treatment was able to help me even though I did everything I could to deal with depression. I ride my bike 20 miles a day and I go to the gym four times a week and none of these things dealt with the dopamine levels. I accept the fact that I have epileptic legs LOL 🤪 and are use the medication provided even though I have to change medication now and then as my body becomes used to it but I follow the expertise on here from various people and my doctor and I find a healthy balance good luck to you. 😊
So it seems you have the secondary form of RLS that is caused by medications. I have the idiopathic and the secondary form.
Idiopathic RLS can remain mild until some "trigger" makes it worse. e.g. an antidepressant. This doesn't make it secondary. Sometimes it can get worse without any apparent trigger.
Secondary RLS refers to RLS like symptoms thast occur as a result of an underlying health condition. e.g. typically thyroid problems, diabetes, neuropathy, end stage renal failure and anaemia.
It's possible to have both, but unless you have one of the known underlying conditions then really it's just idiopathic.
In practice, it's probably not that helpful to differentiate between the two. The strategy is the same i.e. remove the trigger, or remove the underlying condition.
Unfortunately it's not always possible to "remove" the underlying condition.
Sad to hear you've suffered depression for 40 years.
It just depends what things "outside of medication" you've tried for depression. There are effective nonpharmacolgical therapies. Riding a bike and going to the gym may contribute, I wouldn't depreciate them, but they're not therapies.
If your depression is due to a "neurosis" then it should be amenable to an approrpiate behavioural psychotherapy. The term "neurosis", is no longer used in the International Classification of Diseases (ICD 11), however, so that it depends on your particular issues.
You don't say what medication you take for RLS nor what for depression, if any. Hopefully you know that there are antidepressants that are considered to be "RLS safe" and there are RLS medications that don't cause augmentation.
I personally suffer depression because of lack of sleep because of RLS (and other stuff that goes on in my life) which in turn i have insomnia thankfully found an antidepressant that doesn't make my RLS worst took a few years to find one that does work as most antidepressants do make RLS a whole lot worst :/ had RLS since i was about 8yrs old now im 56
I believe they are two different mechanisms, though. This is what I got from the Harvard School of Medicine on the subject:
It's often said that depression results from a chemical imbalance, but that figure of speech doesn't capture how complex the disease is. Research suggests that depression doesn't spring from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems. It's believed that several of these forces interact to bring on depression.
To be sure, chemicals are involved in this process, but it is not a simple matter of one chemical being too low and another too high. Rather, many chemicals are involved, working both inside and outside nerve cells. There are millions, even billions, of chemical reactions that make up the dynamic system that is responsible for your mood, perceptions, and how you experience life.
Well put.
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