How can reducing antidepressants be making RLS worse?

[Soulsister77]

i have had RLS for approx 40 years and it has gone from a once every couple of months occurrence to every night, starting earlier in the day, sometimes during the day and sometimes my arms get it too.

im on 2x Pramipexole daily and have been for quite a few years now and it has worked 90% of the time.

i have also been on the antidepressant Citalopram for many years (20mg) and currently coming off it to move to a different a/d.

I know SSRI a/d’s make RLS worse so what I can’t understand is why my RLS is becoming worse, much worse whilst i am reducing the a/d? I have started taking 3 prami at night - and yes i know about augmentation - but can’t even think about that right now.

It’s 4.30 am, have had no sleep and my legs are bad even whilst i am standing up - which has never happened before.

Please, can anybody advise why this is happening?

Amanda

[BAK524]

Hi Amanda. I had the same thing happen to me. I tried to get off my antidepressant, Lexapro. I tapered extremely gradually, and went from 10 mg to 3 mg over a three year period. The last several months of this were challenging - my RLS increased in frequency and intensity, which didn't make sense to me. I have read somewhere that changes to medications can trigger RLS, but that eventually things settle. This is anecdotal of course. Another thought - reducing an SSRI - I believe may result in an increase in cortisol levels, which can act as an inflammatory chemical on the nervous system, increasing RLS. I suspect if this were the case, eventually one's system would reach equilibrium and symptoms would decrease. (One could only hope).

[Soulsister77 in reply to BAK524]

Thank you sooo much for your response….based on what you’ve said i have decided to revert to my original dose of a/d - it was my request to change but since the reason for that request is the lesser of the 2 evils (jeez, what a mess!) i will stay with the citalopram 20 mg dose…

I already have an autoimmune issue so cortisol is something i am far too familiar with!

Thanks again

Xx

[Madlegs1]

I'm thinking that you are suffering RLS as part of the withdrawal process from the antidepressants.

If you can find an alternative safe antidepressant, then that may help.

Hopefully someone will come on with specific recommendations.

Good luck.

[Soulsister77 in reply to Madlegs1]

Thank you!!

[Butterflysun1]

Could it be chance that it’s happening at the same time as reducing the antidepressant & you are developing augmentation now due to the Pramipexole?Or there’s some sort of interaction between the 2 meds which is changing the availability of pramipexole or it’s effect.

I don’t know what metabolic system they each use for elimination from the body but with other meds there can sometimes be bioavailability effects if they are metabolised by the same set of enzymes.

If anyone on here is a pharmacologist they might be able to think it through or explain?

[Soulsister77 in reply to Butterflysun1]

Thank you!!