I think I know what everyone is going to say but does anyone have anything positive to say about sertraline and restless legs?
If anybody followed my previous post I have stage 4 breast cancer and need a mild antidepressant to help me cope. Having chatted with my GP we both feel I would benefit more from an antidepressant as opposed to something for anxiety ie clonazepam or diazepam which are also sedating - I want to avoid this - bad enough with the chemo.
It was suggested by people on this forum that Bupropion (Wellbutrin) would be a good one for RLS but my GP informs me this is only available through a psychiatrist in the UK and I’m not likely to get an appt with one of those any time soon! So he suggested I try sertraline for 2 weeks to see if affects my legs. I feel I have no choice but to agree (he acknowledges that my understanding of RLS is much greater than his) and he will call me on the 25th to see how I’m getting on.
I think someone on here may have suggested trazodone. Is that available in the UK? Or anything else in the UK?
In the meantime I will try the sertraline and see if it’s as bad as everyone says. I hope not, I could do without any more grief!
Thanks again, Pam.
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Trazodone is an anti-depressant available on prescription in the UK. It can make you sleepy, and the NHS advise if taken once a day to take in the evening. But check with your GP.
thanks Chris. I’ve spoken to my GP. It’s not a favourite of his - he classes it as one of the old ‘dirty’ antidepressants but is prepared to prescribe it if my oncologist is happy. It can cause heart arrhythmia and he is concerned on top of the chemo stresses it may be too much. I have an appt with my oncologist Tuesday so will see what happens then.
"Trazodone is not usually the first choice of antidepressant in the NHS: Doctors usually prescribe it when other antidepressants have not worked or have caused side effects." See what your oncologist says, as long as they balance any potential problem with Trazodone against the widely reported (in this forum) RLS side effects of Sertraline. It's unfortunately likely that any oncologist will dismiss RLS as being insignificant and not give this much weight. Good luck!
I was fine on sertraline for the first couple of months and it worked wonders for my anxiety. I felt like a new woman. It was only after a couple of months that my RLS returned with avengeance. I’m now taking 25 mg of pregabelin at night which hasn’t completely eradicated the RLS but it’s nowhere near as severe, and it sedates me enough for a good nights sleep. It took a while to work, about 3 weeks, but it seems to be helping, and Istill take sertraline in the morning.
The dr mentioned trazadone to me but said it had side effects, though she didn’t say what. I’m happy with the sertraline, as long as the pregabalin keeps the RLS quietened.
that’s really good to know. Thank you. Yes my GP had concerns about prescribing trazadone because of the side effects and how this may counteract with the ravages caused by chemo. I take 150mg of Pregabalin at night and have done for some years. It works well about 80% of the time. So it may be worth me at least trying the Sertraline and not dismissing it straight away. Thank you.
I have been lucky enough to have been under the care of a psychiatrist for the last 12 months. If you look at previous post I’ve been along the well trodden path for RLS. I also suffer with PTSD (ex military) which has many highs and lows to it. I take Pregabalin for the RLS which works well and then because the SSRI’s for my PTSD had made the RLS worse I have been prescribed Lamotrigine. It’s a ‘mood stabiliser’ rather than an antidepressant. Has had no effect on aggravating the RLS and has been amazing at calming all the PTSD stuff. I can’t even imagine what you’re going through with your own current health battles but could be another suggestion for your GPnif you feel it would work after researching it yourself.
thank you - that’s something I’ve not heard of and sounds promising. I’ll do a bit of research and I can put all this to my oncologist when I see him on Tuesday. I feel a bit better now - armed with options.
Good luck to you too. I’m glad you’ve managed to get some support. You hear so many horror stories.
You may not want to hear this but one of the more recent study shows depression is not caused by a chemical imbalance in the brain. This would mean all antidepressants are useless except for the placebo effect.
I went through the depression thing because of my insomnia from rls. I tried pretty much every antidepressant on the market for at least two weeks. Because they say they can take up to two weeks to start working. Not one was of any benefit to me and many of them had unwanted side effects. At least two of them gave me horrific withdrawal when I quit taking them, one of which (clonazepam) led to a full two weeks of shivering in bed feeling like I was going to die and that was well tapering off as my doctor had prescribed. Personally I don't think my depression was ever any worse than when I was seeking treatment for it something about having to fill out forms every time I saw the doctor which asks you to rate your depression on a scale by asking about 30 questions. I also question even if it was a chemical imbalance is it really smart to take medication for depression when you have a actual reason to be depressed. I found the most effective thing was just not to think about and dwell on the thing that's depressing you.
I take your point but it’s very hard with my diagnosis not to dwell on it. I certainly haven’t had to fill any forms in - just a very friendly empathetic chat with my Macmillan nurse and my GP has been wonderful.
I do yoga, reiki, hypnotherapy and all the other things on offer through the cancer charity and I walk daily, so I try many ways of coping. Each one helps a little. If trying an antidepressant that doesn’t effect my RLS helps one little bit more then I will try that too.
But I’m sorry they haven’t worked for you and I hope things become easier. We are all different.
Sorry I didn't mean to downplay your cancer. But my insomnia hasn't been easy for me either it cost me to lose my 18-year career repairing medical equipment, my house, and everything I owned.
Remember years ago Tom Cruise was trying to explain this to people and he got into that fight with Brooke Shields over it. Then all "the view" people attacked him for it, called him crazy? Maybe he was on to something. I don't take anti-despessents so I have no experience in this. Just your comment made me think of this. Then the next logical thought was myabe he was really just trying to help? Who knows. Hope you have success in your journey. I can relate to being called crazy, it's not fun, even if I am hearing things no one else can hear.
I hadn't heard about that. Just read up on it now. I wonder what Tom knew, is this not the first study to show this? Because this study just came out a few months ago.
I'm not sure, me nor Tom is a medical professional. But I had not heard of this study, then when I looked it up I immediately thought about that. Thank you for bringing this study to my attention, it is very interesting.
I take trazodone for my insomnia, not my RLS. I did take Zoloft (sertraline) for a short time for depression, but I soon took myself off it due to a side-effect called "bruxism" which causes you to clench your jaws/teeth. It was quite unpleasant. The only thing that works for my RLS is simply Hyland's Restful Legs. I'm sure you can get it online; it's a perfectly harmless supplement and my RLS symptoms simply disappear after about 30 minutes!
I took sertraline for post partum depression. It was my 4th child and I'd had PPD on the previous 3 and battled through it. I can tell you for a fact it was no placebo. It worked amazingly (side effects for 1st 2-3 weeks were pressure behind my eyes- I even went to my optometrist for a check up!) And I wouldn't hesitate if I happened again to take it. For me. I can't say it affected my RLS to any major extent. I just know it made me able to cope so much better.
I personally would say try it and you can always come off it if it doesn't workor worsens RLS. Just because it worked for me doesn't mean it'll work for you.
I'm afraid I don't believe antidepressants are placebos. Been there and done that....They worked.
While a rapid, doctor-ordered discontinuation of Sertraline literally caused my PLMD to begin 2 days after the last dose, it apparently can help with anxiety though, from what I’ve read, the evidence is thin for this and has only shown effectiveness for social anxiety disorder, not others. My doctor has said that both Sertraline and Bupropion are activating - some affinity for dopamine system.
Gabapentin is the primary calming neurotransmitter in the brain so if it was me, I’d try that before Sertraline. Also, the affect of Sertraline on anxiety, if any, is likely to be quite small as the studies reveal. A problem with Gabapentin is that the dosage needs to be high enough and many people and doctors think that 300-900mg is enough. It isn’t. RLS guidelines for gabapentin is 1200-1800mg/day. My sister is a nurse and says that she sees patients on 2500-3600mg/day. It will cause sleepiness in the first 1-2 weeks but then resolves pretty quickly.
I wouldn’t write off low-dose, long half-life benzodiazepines. They have the benefit of working quickly and well for anxiety. They can be counted on basically. The key for me is to set a limit for the max dose you are willing to take because, with tolerance, it’s effects will wain over time and you’ll have to decide whether to continue increasing the dose. But, that may be years down the road. I took 0.25mg/2x/day at one point for several years without needing an increase. Withdrawing from a low dose is relatively easy as long as you do it very, very slowly.
The added advantage to Gabapentin and say, Clonazepam, is that they both have shown some benefit in treating RLS & PLMD. For PLMD, both worked well for me for years but CLonazepam the most effective. I’m pretty sensitive to withdrawal symptoms but I recently reduced my dose from 2mg/day to 0.375mg/day over 4 months. Surprisingly, it wasn’t as difficult as I thought.
It’s a tough decision to make. + & - with everything.
Dear Pam, my heart goes out to you as you overcome multiple health problems. I can’t imagine the burden you carry right now. As I read your letter, my thoughts turned to my own treatment right now of RLS and how my life has been changed by the use of Methadone or Metadol as it is called in Canada.
What is the interesting things about Methadone or Metadol in Canada is that it is often only approved for cancer patients and people withdrawing from hard drugs. This might mean that in the UK you absolutely qualify to be put on methadone because of your cancer treatments etc.
I would highly suggest you look into this. I began Methadone almost one year now to the day. It has absolutely changed my life in regards to RLS. I’ve taken nine hour airplane trips, I go to movies, I can lay in bed with insomnia and I’m just happy because I don’t have restless leg I’m on very low doses I only take 3 mg a day and that usually holds off my RLS for 24 hours. Other than the usual minerals/ supplements I don’t need any other drugs. Though I have been on low dose Wellbutrin for ADD for over a year, so maybe they are working together . However I did have RLS when just on Welbutrin.
it’s just a thought and others know way more than me about interactions of drugs etc. but I feel like you’re in a situation where you might actually have simple access to methadone and it could be life-changing as far as dealing with restless leg syndrome and pain .
My heart is with you and I will keep sending up prayers on your behalf. I just came home from 10 weeks in your delightful country, so it seems closer to me now!
At the moment my RLS is fully under control with Pregabalin and as yet I’m not in much pain. It’s a suitable antidepressant I’m wanting and the advice seemed to be Wellbutrin but unfortunately that is only available over here if prescribed by a psychiatrist. It’s interesting though that you say when you were just on Wellbutrin you had RLS. Im beginning to wonder if any antidepressant will work for me. Life throws us some crap doesn’t it?!!
Im glad you enjoyed it in the UK although I fear it’s as broken as I am at the moment. These are grim times.
I am sorry that I missed that. I also need to reiterate that I was on a low dose of Welbutrin which I take along with Escitalopram. Either one on its own didn’t quite crack the issue of depression or anxiety but the mixture of Escitalopram and Welbutrin has made a big difference to the severe social anxiety I have had since childhood. They may also have contributed to helping the RLS as I started Welbutrin just awhile before the Methadone. I feel like a different person which made this trip ti the UK so amazing! Is it possible to order Welbutrin online I don’t know anything about that so not advising it Just wonder if anyone has knowledge of that…
I am hoping that this is the dark before the dawn as people realize what they are bringing down on themselves and their fellow countrymen. It’s my third time petsitting and living in the UK. It just has a special place in my heart.
Take care and hoping for some real breakthroughs for you, Teresa
I have some friends that pet sit and it takes them all over. What a brilliant thing to do!
And yes, we have abused this wonderful planet for too long. I recently read The Book of Hope (for our endangered planet) by Jane Goodall. And it did give me hope that it’s not too late. It’s an inspirational read and one I can really recommend.
I have suffered from RLS for 30 years. When first diagnosed I was prescribed Pramipexole to get rid of the RLS and Trazodone (which he described as a low level antidepressant) for insomnia. (I had had a serious run in with sleeping pill addiction and I can tell you this is no fun at all.)
This probably saved my life! I had been drinking heavily to combat insomnia and I was in a bad way. The Trazodone transformed my life. For the first time ever I could go to bed and sleep and it may have helped with my state of mind but I was so happy to get some sleep that I didn't care.
As everyone now knows the Premipexole was a VERY bad idea but the Trazodone worked perfectly for over 20 years... and then stopped working. I took the same dose for the entire time. No side effects and no withdrawal. !!!
Did it effect my RLS? I have no idea because presumably the Premi was taking up the slack. Now I am suffering augmentation from the Premi and but I don't think the Trazadone did me much harm.
I started on Elavil (with weight gain) and Trazodone for grief, but then took Sertraline for years. It worked for mild anxiety and a sort of pre-clinical OCD, but I've been Duloxetine for at least 9 years because it also helps with cervical stenosis. Never noticed any correlation of Sertraline with RLS. PLMD is severe now with both increased following broken femur/surgical implantation of screws and rod.
many thanks for everyone’s input and some positive instances!
I’ve seen my oncologist today - Wellbutrin is out as it’s only available in the uk through a psychiatrist, trazadone is out because it is not recommended alongside chemo but Sertraline has been given the green light. So I’ll try that. I guess I’ll know pretty quickly if it affects my legs or not!
It is available in the UK as my GP gave me a prescription. However, as I have been weaning myself off sertraline I haven't tried it yet. I've managed to reduce Sertraline from 75 to 25mg so should soon be ready to try Trazodone! Will report back when I've given it a trial!
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