Did Antidepressants (taking or stopping) cause your RLS

[ircam2112]

My RLS/PLMD began 2 days after a doctor-ordered rapid tapering of Sertraline (Zoloft) back in 2004. I’m wondering if there are others who’s RLS and/or PLMD began while taking or after discontinuing an antidepressant?

[jcsphilippines]

I suspect that my rls came several years after starting Prozac and Nortriptylene. The doc just put me on Ropinerole without warning of augmentation. It was 20-25 years ago. I’m off all three now.

[ircam2112 in reply to jcsphilippines]

And no more symptoms? My PLMD has continued to the present.

[SueJohnson in reply to ircam2112]

Are you taking any medicines for your PLMD? Have you had your ferritin tested? If so what was it?

[ircam2112 in reply to SueJohnson]

Yes, still taking medications but currently tapering off as many as possible. Ferritin 137. Total Iron 176. Saturation 40%. Binding capacity 296.

[SueJohnson in reply to ircam2112]

What medicines are you taking?

[ircam2112 in reply to SueJohnson]

Right now I’m taking Clonazepam, Oxycodone (for chronic back pain, 10mg at bedtime), Zolpidem ER (sleep continuity) + Bupropion for depression. Will be starting to reduce Clonazepam 0.25mg/3 weeks this week.

[SueJohnson in reply to ircam2112]

I notice you tried gabapentin in the past but see you are not on it now. If it stopped working you probably were not taking enough. Most people need 1200 to 1800 mg a day and the maximum is 3600 mg.

[ircam2112 in reply to SueJohnson]

Yes, thank you. I encourage people frequently to not give up on it too soon as I did initially. I stopped at 900mg but a couple of years later it suddenly had benefits when I began to take 1200mg. I was on 1200 for years then on 1500mg for a while but the increase didn’t help noticeably. I’ve found that with all my medications that they all worked very well initially but, with tolerance, the benefits wane over time. I’ve reached a point where the costs of recent increases haven’t been worth the almost indiscernible benefits I’m getting, likely due to tolerance. So, I am slowly discontinuing all of my medications, one at a time. The biggest obstacle has been extreme EDS. My PLMD is worse but doesn’t seem to be proportional to the incredible increase in EDS. I’ve discontinued Pregabalin over 6 weeks (was on max daily dose) and last week discontinued Gabapentin after 6 weeks. Now starting to very slowly discontinue Clonazepam (0.25mg/3 weeks) and working towards a rotational medication regime which will include Pregabalin, Oxycotin, Clonazepam and either Gabapentin or Zolpidem ER, each for a week. While Gabapentin works well, it takes a while to titrate up to 1200mg so we’ll see on that. Since I’ve been off Pregabalin for 6-8 weeks, we’re adding that back in now for 7 day periods coinciding with each decrease in Clonazepam to help with PLMD control and withdrawal symptoms. Once I’m down to 1mg or 0.75mg Clonazepam, I’m going to ask to have the Oxycotin introduced for 7 days each month, probably following Pregabalin. Then, Clonazepam will follow Oxycotin, since it is a treatment for opioid withdrawal. My hope is that this schedule will maximize benefits, avoid tolerance and dependence, overall reduce the amount of medication I’m taking and still have good control over my very severe PLMD.

Also, per my original post above, I’m still holding out hope that the reintroduction of Zoloft recently may have “cured” the PLMD as it’s the only “cure” that I’ve found in my research - going back to the original dose and very slowly discontinuing. Part of what drives this hope is that I began to have daytime symptoms half-way through discontinuing Pregabalin (at 150mg) and Gabapentin (at 600mg) but they eventually went away so the recently initiated Zoloft may be doing what is hoped it will do.

My doctors have been very open to this plan. I feel quite lucky. Fingers crossed.

[Biscuitface in reply to ircam2112]

Buprenorphine in form of Temgesic has given me anxiety. What dose are you on please?

[Amrob]

Yes, I first noticed RLS (or PLMs) over 20 years ago when I took an SSRI (Effexor).I took it for 1 to 2 years. I believe it was RLS that I experienced at the time however much later, i was diagnosed with PLMD.

I have since been told that SSRIs can trigger or 'turn on,' RLS, but not cause it.

[ircam2112 in reply to Amrob]

Thanks for the reply. I was first diagnosed with RLS then PLMD later as well. I’m not sure what the difference would be between “triggering”, “turning on” or “causing” RLS/PLMD. They all mean the same to me: I didn’t have any RLS/PLMD, I took an antidepressant then my RLS/PLMD began. If you don’t mind me asking, which antidepressant? How long ago? Do you still have symptoms? Thanks.

[Amrob in reply to ircam2112]

'Trigger' means to turn on a condition that you already had a disposition to . That is, an underlying condition that hadn't yet manifested.

By 'cause", i mean that the medication results in you developing a condition that you didn't already have.

I took Effexor SR.

Reflecting on it further, I was never a good sleeper, possibly the PLMD.

The RLS which I no longer seem to have, may have been a direct result of the Effexor, as it was limited to the period in which I took it. (It was ~24 years ago so my memory a little hazy).

[ircam2112 in reply to Amrob]

Do you still have PLMD symptoms and, if so, what do you take for it?

[Amrob]

Yes i still have PLMD and i have been taking pregabalin for several years. It works 70 - 80% of the time but i'm loathe to increase my dose. I'm already taking 300mg which causes considerable daytime side effects.

[ircam2112 in reply to Amrob]

Tolerance to Pregabalin is estimated to occur with 6 months to 1.5 years based on my research, so you’ve likely become tolerant to a degree that it isn’t as effective as it was when you first started.

[ircam2112]

I’m sorry you still have it. We’re in the same boat so to speak. Which medication do you think caused it? Effexor? While taking or after discontinuing? Is it during the daytime and at night? I want to tell you more but have to keep it short right now. Talk to you soon