New here! I'm wondering if my RLS is due to Sertraline (Zoloft) I'm taking for depression/anxiety? Or perhaps 10 days of Mirtazapine?

[1brightongirl]

I started 25 mg Sertraline about 2 months ago and I don't recall having RLS at first. My psychiatrist increased the dose to 50mg and, shortly after that, I had restless legs for the first time in my life. It's been happening for about 2-3 weeks now and is getting worse, i.e. more frequently with more intense feelings.

At first it was sporadic, happening only sometimes. It would begin about 10 minutes after lying down to sleep; my calves would start to tingle/tickle and I felt as though they were mildly throbbing. I'd have to shake my legs out to relieve the feeling but 10 seconds later it would start again. Eventually I'd get up and walk around, drink some tea, "re-set" my body then try to sleep. But it would start again - and I'd restart the cycle until I eventually fell asleep.

Now it happens every night, every time I lie down. I now get so frustrated and end up watching TV, go online - anything as a distraction. And it's in my thighs plus my arms too- I have to clench and release my fists and shake out my arms. It even feels like it's in my abdomen. I don't get to sleep until about 4-7am and I sleep in 2-3 hour stints. Luckily, I'm retired so it's not affecting a work schedule but still, it's exhausting and I'm over it!

The depression/anxiety has improved but it seems to be replaced by another problem and I'm weighing the cost vs. benefit. I wonder if it is the Sertraline or a coincidence? I should say that I also started Mirtazapine for about 10 days for mild insomnia; it didn't help so I stopped about 2 weeks ago. Could this have triggered RLS? And surely it would have stopped by now?

I'm tired and confused and would be grateful to hear from anyone with RLS who has experience with these medications.

[SueJohnson]

Both drugs can exacerbate RLS symptoms. They don't cause RLS but they might have brought it to the surface. Wellbutrin is safe for RLS and there are others if you can't get it.

[Eryl]

Your rls, depression and anxiety could all be down to inflammation of the nerves both in the brain and in the peripheral nervous system. This inflammation is most likely due to the diet containing too much carbohydrate especially refined carbohydrate from processed food or sugary drinks and sweets. Another major cause of inflammation is refined seed oils as in vegetable oil for cooking and margarines. youtu.be/TXlVfwJ6RQU(Not working as expected?)

[Seaux]

YES! It is well known to exacerbate RLS!!!

[DicCarlson]

There is something else going on. These drugs can help RLS along but not CAUSE it! Have your iron status checked - a full iron panel detailing your Ferritin Level, % Saturation, etc. I had RLS out of the blue and iron deficiency was the cause (why I was deficient, I never knew). Supplements saved me - no thanks to docs who said iron status was normal!

[ircam2112 in reply to DicCarlson]

Sorry, but not true. See below comment

[Searchinforpeace in reply to DicCarlson]

I believe some people are prone to it and the medicine kicks it into motion. I did some reading. Seems like stiff muscles, restlessness, inability to sit still, uncontrollable limb movement, muscle spasms, jaw clenching during sleep and akathesia are the least common side effects and in my opinion it's all about the same thing. Serotonin syndrome is a side effect as well and I feel like it may some how play a part.

[FluteE]

Not sure of your cause (don’t know why I have it) but Sertraline most definitely will make it much worse. I have been on it for years and thought I was augmenting with the Pramipexole .25mg. Stopped taking Sertraline and the next day I took Welbutrin. No issues at all. RLS dramatically better!! Now only take 1/2 dose of Pramipexole… wasn’t augmenting after all. Be sure to research meds that make RLS worse before starting anything new or letting them give you stuff at the hospital (they haven’t a clue!). Long story short… do not take Sertraline!!

[ircam2112]

I’m so glad to have seen your post! Yes, it is absolutely possible that your symptoms (parathesias) are caused, not just exacerbated by, taking Zoloft. I’m another case study. I had no RLS / PLMD ever prior to taking Zoloft back in 2004, though my symptoms began upon discontinuation. 2 days after discontinuing Zoloft I developed severe PLMD (Periodic Limb Movement Disorder - involuntary movements) which has never gone away. Though apparently rare, you are not alone! At first it only affected my legs whenever I rested for 5-10 minutes but were worse right at bedtime and occurred all night as well. Now they involve my diaphragm (abdomen), shoulders, arms and neck muscles. I also developed dizziness, “brain zaps”, headaches with visual disturbances, GI issues, akathisia, bruxism, excessive daytime lethargy and much worsened depression. Only the “brain zaps, headaches with visual disturbances and dizziness resolved within a few years. These are also classified under Antidepressant Withdrawal syndrome (AWS) and Antidepressant Discontinuation Syndrome (ADDS) which few people are aware of. I’ve attached just a few screenshots that support my claim and our experiences. I’ve also spoken to others and watched videos on YouTube from people who claim to have developed movement disorders while taking or just after stopping Zoloft (and other antidepressants). Since it appears you have a predisposition to develop symptoms, my advice, though not a guarantee, would be to discontinue the Zoloft but to do it very, very, slowly e.g. 10mg every 2-3 weeks and while doing this (if you absolutely need an antidepressant), switch to a longer-acting antidepressant such as Prozac or, better yet, an atypical antidepressant like Bupropion (Wellbutrin) or even an MAOI. I’d also ask your provider to prescribe a low dose RLS treatment while you are discontinuing to reduce the chances that the symptoms become permanent e.g Ropinrole, low-dose opioid, Pregabalin or Gabapentin. The symptoms hopefully will resolve on their own but for your long term health, act as soon as possible. Again, slow tapering of Zoloft. The absolute worst thing you could do is discontinue it abruptly or too quickly. While tapering off, if you experience a worsening of symptoms, my advice would be to go back to the previous dose of Zoloft, take that dose again for a week, then try the reduction again but, by half of what was first attempted.

As far as cause, my guess is that the combination of Mirtazipine and Zoloft or, if applicable, a rapid discontinuation of the Mirtazipine, was the initiator of symptoms. There’s a good chance that your symptoms will resolve on their own with the cautions above and because you reached out so soon, but they could become permanent I’m sorry to say. If that unfortunately happens, please keep my info.. Please reach out if you have questions now or anytime. Best wishes

[SueJohnson in reply to ircam2112]

Prozac causes worsening RLS symptoms in most people and MAOIs can cause potentially serious side effects so neither should be recommended.

[ircam2112 in reply to SueJohnson]

Then what would you recommend to someone if, as I say, they need medication to control their depression?

[SueJohnson in reply to ircam2112]

Wellbutrin is safe for RLS.

[1brightongirl in reply to SueJohnson]

Thanks but I already take Wellbutrin and the Sertraline was added as a boost.

[Searchinforpeace in reply to 1brightongirl]

same! I do have to say that was tur absolutr best I have ever felt. Until the RLS kicked in:

[ircam2112 in reply to SueJohnson]

Read my comment again please. “….or, better yet, an atypical antidepressant like Bupropion (Wellbutrin)”.

[ircam2112]

The attachments

Case studies

[ircam2112]

It appears that i can only attach one image/file at a time and limits # of posts too. I’ll attach more info tomorrow.

Wiki page

[Lou9]

I am 16 months on from trying Mirtazapine, then Paroxetine, followed finally by Sertraline before coming off them cold turkey due to horrid exacerbation of RLS amongst a whole host of other terrible neurological symptoms. Not sure if you are aware of the peer support website ‘Surviving Antidepressants’ but if you Google it and take a look at the thousands of posts on it, you will see you are most certainly not alone. I am still dealing with my side effects, the only things that help a little are magnesium and Omega-3 supplements. Hope you get some relief soon. 💕

[ircam2112 in reply to Lou9]

Thanks for the info Lou.. I wasn’t aware of that website

[DicCarlson]

Well - this is all good stuff. I can stand corrected and I wish researchers would use these "case reports" to hone in on the causes of RLS.

[ircam2112 in reply to DicCarlson]

I hope so too. It’s especially frustrating since this has been known since the 1990’s at least. My provider had never heard of AWS or ADDS until I informed him last year and had to remind him of it again last week so I assume he continues to not warn his other patients or change how he discontinues antidepressants which ironically, is depressing.