ADHD and RLS. (Does Ritalin help RLS or exacerbate it?)

[RestLessLeg]

Has anyone else on the forum been diagnosed with ADHD on top of their RLS and has Ritalin helped the RLS eventually or am I going down another dark path?

Do the side effects of Ritalin wain over time?

I finally saw a psychiatrist 3 days ago.

I explained to him I’ve been suffering from RLS for 10 years. I was hoping to trial methadone as my low dose Temgesic has not been effective. I’ve been relying on orgasms late in the night (with a little extra temgesic afterwards) in order to get me to sleep but this is proving more and more difficult and the resulting orgasm is less effective as the symptoms start to return before getting to sleep.

The psychiatrist asked who diagnosed me with RLS. I told him about the matching criteria for RLS and that it was agreed to be RLS by my original doctor. I had trouble reciting all of the 5 criteria but ended with saying that it could not be explained by any other condition.

He then gave me a form to fill out. He folded the top before giving it to me. The diagnosis criteria sounded very familiar and I became very emotional answering the questions and broke down before the end. When I finished he told me to unfold the top and read it to him. It said ADHD (adult assessment) After going through further criteria he then diagnosed me with Severe Adult ADHD.

It seems to explain a lot of my problems over the years, even before RLS. Ive probably been suffering it for most of my life. (Later I looked online and discovered a definite link between ADHD and RLS.)

He then referred me back to the RLS criteria I mentioned and pulled me up on the last one that states: “there is no underlying condition present to explain it”.

In other words I guess he was saying that if I treat the ADHD I’ll treat the RLS.

He then prescribed me Ritalin 10 (10mg) starting with half a tablet twice a day before titrating up to 1 tablet three times a day. I had lots of questions but couldn’t think of them at the time.

He said this would be a ‘game changer’ and in 4 weeks should start to see a change.

But now that I’m not so sure. Since the appointment my RLS has been worse, extending to other parts of my body and not allowing me any sleep in the morning which is my only relief. Was still taking Temgesic/clonazepam although he wants me to come off them. The last Ritalin tablet is supposed to be taken at 8pm under his instructions so it seems I’m supposed to go the night without anything else. I tried 5mg of oxycodone last night in desperation and things seem to settle for a while and I almost slept then all sudden both legs began jerking and spasming. Out of desperation I ended up taking half a Ritalin tablet and the sensations stopped in one leg so I took another half and eventually they both settled with the help of a cold pack on one thigh. I couldn’t sleep but I was at least relatively comfortable..

However, my left arm eventually became restless with pain/stiffness. I had to ice that too. Whenever my mind seems to drift towards sleep something always jerks me back awake.

The Ritalin seems to ease my symptoms but it appears to have side effects such as insomnia amongst other things. Also, the RLS seems more pronounced and moves around my legs, feet and arms. I’ve now gone 3 nights without sleep. I cannot continue going without any sleep despite whatever benefits Ritalin may have in terms of my mental state.

Apologies for the long winded story.

[SueJohnson]

Ritalin is a stimulant and if the effect has not worn off by bedtime will exacerbate RLS symptoms. Ritalin does increase dopamine but is not used to treat RLS. ADHD and RLS are often found together and if you meet the other criteria for RLS having ADHD does not mean you don't also have RLS. It's a shame Lyrica didn't work for you. Have you had your ferritin checked? Have you tried dipyridamole? It sounds like you may need to switch doctors or go back to your original doctor.

[Hidden]

Hi RestlessLeg, it sounds like you're dealing with a lot right now so my sympathy to you. I have read that ADHD medication can improve sleep quality in ADHD populations.Meds such as Ritalin are given to help daytime functioning. The dose may need to be adjusted so that the effects have completely worn off by bedtime. Do you actually need a night time dose of Ritalin?

There's also a common link of low ferritin levels in both RLS and ADHD populations. I'll try and locate the article i read recently on that subject.

Do you have access to a good sleep specialist you can ask about Ritalin? I'd expect they'd have patients with both conditions.

[RestLessLeg in reply to Hidden]

To be honest Amrob,

I’ve dealt with ADHD probably for most of my life without knowing so I can probably live with it as long as I get sleep. Ie: getting my RLS under control is the important thing not so much the ADHD

Taking even a low dose of Ritalin for 3 days then stopping it today showed me how much worse I feel mentally when coming off it.

My mum came to visit this afternoon before work) which I shouldn’t have gone to as I was exhausted) I couldn’t sit down. I couldn’t focus on her words. I had to keep moving around. I could do without that to be honest. If that’s what withdrawing from Ritalin is like. Imagine if I was on a high dose for a long time? Scares me to think about it.

Anyway… Tonight after work at 11pm I was bracing myself for another sleepless night with worsening RLS symptoms and I was right. When I got home I had a shower and tried to relax. I took .5 clonazepam them a little after that I took a whole temgesic 200mcg under the tongue then lay down in bed. Even before I lay down I could feel the pain in my heels and aching that ran up my calves to my hamstrings which makes me constantly want to stretch them. These pains in my calves/hamstrings I haven’t had for two years since getting off the siffrol. I feel this was brought back by the Ritalin/zero sleep the past 3 days. When I lay down I immediately began twitching and jerking. I had to get up. I couldn’t even sit down on the lounge without the terrible jerks which doesn’t normally happen.

Anyway, my Temgesic seems to have kick in now and removed the aches, even my heels are relaxed. The tugging spasms are home too at this stage thank god.. Whatever happens tonight (I hope sleep) I’m just happy that I can at least sit down. I was dreading a night of walking around my apartment all night.

So that’s a blessing. After the torment of the past 3 days I’ve taken an extra 200mcg which I don’t normally do but I could do with some sleep. Fingers crossed.

In regards to night Ritalin I shouldn’t have taken the Ritalin at night as Sue said. I was so desperate last night I took a Ritalin tablet in the middle of the night to settle terrible RLS in both my legs at the same time which doesn’t normally happen., although it seemed to help I still had insomnia so I couldn’t sleep anyhow and later it gave me pain/stiffness in my arm which kept me awake til morning.

Thanks for your post. X

[Eryl]

The link between ADHD and RLS is cause and that cause is your diet which I suspect contains a lot of refined carbohydrate i.e. processed food. The most damaging processed foods includes such common things as bread and fruit juice as well as sugar.

[serengazer in reply to Eryl]

Hi Eryl.I agree with the negative effects of refined carbs. But just as an aside, i have been very intolerant of sugar, gluten and lactose for most of my life. Haven’t touched foods with any of these products for over 20yrs and rarely eat anything refined I make everything from scratch. Yet I have had incapacitating RLS and ADD all my life. The change in my diet didn’t help and it has continued to get worse with age !

I am wondering if this is another example of what triggers these conditions in different people. Maybe a different trigger needs a different cure. The only thing that has changed my life completely is taking low doses of methadone. I started last November and am now at 3mg. I haven’t experienced RLS since, unless I mess up my dosing times.

However the other benefits of the lifestyle you propose have been amazing, including my skin not aging Doctors and studies have suggested that has been the absence of any refined sugar or cane sugar in my diet. I believe it!

All the best to everyone suffering from RLS. I had to badger my doc till he finally put me on Methadone. We are both thrilled with results. He is now a believer!

Take care Teresa

[Eryl in reply to serengazer]

Another cause may be refined seed oils, or you may be sensitive to oxylates or nightshades.

[ziggypiggy]

Results may vary. I have been diagnosed with adhd. I'm allowed to take the smallest fast acting dose as early as possible in the morning so as not to effect my sleep at night. Even then it's a crap shoot. I often have sleepless nights following taking a morning adderall dose. I now only take it on days where I'm driving over a couple hours as i tend to get drowsy at the wheel. Safety first. Even though adhd medication is supposed to exist your system fairly rapidly you will find plenty of anecdotal evidence online of people having difficulty sleeping on adhd meds taken in the morning that are supposed to gone by bedtime.

I do take opiods for RLS and I find they manage my ADHD symptoms fairly well. I take a daytime and nighttime dose.

Everyone is different.

[RestLessLeg in reply to ziggypiggy]

Hi ziggy,

I ended up starting the Ritalin again today.

Seems there was a miscommunication with my psychiatrist who seemed to think I was working night shifts. I said I do shift work generally between 12pm and 12am but for some reason he took that as I start from 12 am.

So he had me taking my last 1/2 (10mg) tablet at 8pm at night! The latest dose should be no later than 3pm. No wonder I was struggling for sleep . Even after that was sorted I was still reluctant to go back on it. I’m worried (as you said) that the Ritalin will still be in my system enough to cause insomnia. I’m also worried about potentially worsening RLS symptoms.

Will have to see what happens I guess.

[April2213]

Although this post is 3 years old but I can totally relate to every single word you wrote. My restless legs was controlled with requip 2mg but as soon as I started ritalin I experienced the worst nightmares of my life....RLS worsened to an extent that nothing worked and my upper body also started getting affected which never happened before. Unfortunately I thought Ritalin doesn't worse. RLS and I didn't stop ritalin earlier and had to resign from my job due to sleepless nights and excruciating RLS symptoms. I wish I knew earlier and my job hadn't gone.🥺

[RestLessLeg in reply to April2213]

Hi April,

I stopped taking Ritalin not long after these posts 3 years ago. Between paying excessive amounts of money to a psychiatrist who was unsympathetic to my situation (I came to him initially about my RLS which he did/knew nothing and in the end made it even worse by prescribing seroquel), the insomnia and the terrible depression that came in the late afternoon/evening.

I honestly can’t remember whether or not Ritalin made my RLS worse (I suspect it probably didn’t) but I’m glad I’m not taking it anymore. I’m still taking between 400-500mcg temgesic per a night and avoid trigger foods as best I can. Masturbation is an occasional last resort if symptoms are persistent.

I still get RLS (generally starting in the heels of either foot and occasionally becomes twitches/jerks in either leg or sometimes my arms) but in general quality of life is better than 3 years ago. It would be nice to address the problems ADHD cause but I won’t be taking Ritalin again.