Are RLS Symptoms from Antidepressants Dose-dependent? Will lowering the SSRI dosages help?

[Walks_a_lot]

Hello my friends. Can you help me with this question?

For background information, I have had RLS since I began taking antidepressants 10 years ago for depression and anxiety. The RLS is mostly mild, with unexplained ups and downs, acute periods and then chronic but low intensity periods. I was off antidepressants for a few years but I am back on them again recently. My medication is:

AM: Prozac (Fluoxetine) 20mgs

PM: Clonazepam (Klonopin?) 0.5mgs

I have been taking the benzo both to help with the RLS and for anxiety. My anxiety seems back under control. But the RLS is clearly aggravated by the Prozac once more.

I am confident that I could take lower doses of Prozac and be okay. But some effects of drugs are dosage-dependent, and others are not (some drugs are just flat response). I want to know if the severity of RLS symptoms depend on the amount of antidepressant drugs one is taking or not?

Can anybody with experience help me with this? I'm sure someone has thought of this before. I think an answer to this would be very helpful to a lot of people on this forum. It would be really cool if a person could whittle down their antidepressants to a point where they were just enough to control their depression/anxiety/panic/OCD problems, and thereby reduce to a minimum the burden of dealing with the RLS.

I'm going to try this anyway. I'll experiment on myself. I think I will try 10mgs of Prozac first, and then maybe even 5mgs if all goes well. We shall see ...

Even if no one has an answer or some experiences to share, thanks for reading anyway.

Michael (Walksalot).

[Madlegs1]

I don't have direct experience of your meds, but just wish to comment on the "unexplained ups and downs etc"

I suggest these are caused by direct triggers. It might be an idea to look at your diet around these times. Food diary?

There are a huge number of triggers, I've written about them here extensively.

As to trying out various doses, if your primary care person is happy, I would certainly give it a go.

I'm sure someone will come on with better information as soon as they all wake up.

Cheers, and let us know how you get on.

[RoadRunner44]

Hello, I hope I may ge of help. There is a very knowledgeable man on this forum who goes under the name of Manerva. If there's anyone, he is the person to advise you. Hopefully he will read your post. Maybe you could send a private message from your profile page.

Out of interest, I thought I may have had restless legs or some form of neuropathy due to the medication I was taking back last January.. At the time I was taking the anti depressant Citalapram. Manerva explained that certain anti depressants could make restless legs worse and this was one of them on the list. I came off them slowly and I don't have any of the symptoms at all now.

I hope Manerva reads your post as I, like many others, have great respect for his understanding, knowledge and good advice.

Good luck.

😀

[Hidden]

Hi, I had mild RLS for decades, then had a course of an SSRI and my RLS became severe and not knowing about the SSRI, I ended up being referred to a neurologist, prescribed a dopamine agonist and consequent downward spiral of worsening RLS for years. Despite stopping the SSRI.

I'm not sure if there is a dose of an SSRI that is low enough to avoid RLS symptoms yet still sufficient to have the desired effect.

I appreciate that it must seem hard to face but SSRIs do not "treat" anxiety or depression, they control symptoms and they are meant only to be used short term.

It's indicative of the inadequacy of mental health services that people aren't helped to deal with their mental health issues, but are left on such things as SSRIs indefinitely.

Ideally, you should seek psychological therapies.for your issues which can be effective and stop the SSRI entirely. I appreciate that it's not easy to access these, but otherwise you may be "piggy in the middle" between your anxiety and your RLS indefinitely.

You might also consider, as Madlegs says, there might be other triggers affecting your RLS. Diet could be a factor, added sugar, simple sugars or refined carbohydrates in foods can be a trigger. Alcohol is a trigger. Caffeine is a trigger for some people.

If you have any food allergies, this could be a factor.

You might also try the food supplements that are commonly suggested for someone with RLS. Iron is the most significant of these, but also magnesium, vitamin B12 and vitamin D.

You can find out more about iron and RLS from the pinned posts on this site.

[Nlthomp]

Hi,

I am taking a low dose of bupropion hcl for depression, caused by severe RLS. It really has helped and has no effect on RLS, as it is not an SSRI. Maybe you could ask your physician about switching.

Good luck 😊

[Hidden]

I had a major depressive episode in 2006. I was burned out at work and gave notice, was helping my professional Infection Control group put on a workshop and was out of control with my eating addiction. I actually stopped on the Sunshine Skyway Bridge over Tampa Bay with the intent of jumping off. I did not want to do that and hurt the man who would become my husband after marriage equality passed.

Fortunately, the director over my job came in, sat down to talk to me and related her problem with severe depression. To bottomline this story, I took 3 weeks off, went to the Employee Assistance Counselor and got into therapy and he recommended Prozac to my GP.

I started on it and what a difference it made. I had little highs and lows and realized this is what other people felt like, rather than being angry all the time. For the first time in my life I felt normal.

My RLS had always been of variable intensity when I was younger with months between episodes a time. This was one of those periods. Finally, I had to pay the piper as my RLS spiraled out of control a year or so after that. They took me off Prozac, My well-meaning GP began cycling me through all the other SSRI's with different side effects. Zoloft has sexual side effects for me. Paxil made me anorgasmic no matter what I did. To use a metaphor, "I had the desire to sit down at the table, I could actually sit down at the table, I could stay for as long as I wanted at the table. but could never eat a meal" It was the most frustrating thing I have ever had happen. They dinked around with several others but they all exacerbated my RLS. I finally was started on Wellbutrin XP. This helped the depression but it did not feel the same. Prozac was a "warm fuzz" sort of feeling, but Wellbutrin XL is more of a cold-prickly feeling. Both treat the depression.

I tried to go back on Prozac one last time but it immediately sent my RLS into orbit. This was in the the middle of the last decade. I have since stayed on Well-butrin XL since that time and it has kept my my depression at bay in its own way.

Hope this helps with your question.

Jerold in Citrus Park, FL

[Seaux]

Yes, all the SSRIs make RLS a lot worse. I have read that the only AD that will not worsen RLS is Wellbutron