I weaned myself off of Sertraline in the summer as partly responsible for worsening my severe RLS. And I had an iron infusion in August. For the last 4-5 weeks I have been symptom free of RLS, though still on 50mg pregabalin.
But I find myself at an all time low for other reasons - and am in need of a new anti depressant that doesn't impact my RLS.
Does anyone have experience of bupropion - the drug recommended in the Mayo Clinic algorithm? Or Trazodone?
Best wishes and thanks.
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veronal
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I use the Bupropion and also have serious RLS and it’s worked ok.I’ve been using this for a couple years now and believe I need to have my first higher mg. I will be talking to my doctor in January.
I tried bupropion and it made me feel agitated - like I had downed 6 high caffeine drinks. Ultimately I was helped with CBT (cognitive behavioral therapy). I suspect that my decades on Citalopram induced or abetted my RLS - I had no idea at the time. Thank god I didn't seek medical help at the time - they would have put me on a dopamine agonist.
I believe that you are in the UK? Most of the Replies you've had so far are from members in the US...
Bupropion has not been licenced as an antidepressant in the UK (it's used to help get off smoking here) so you'll need to have a GP ready to prescribe it off label.
And there are restrictions on prescribing Trazodone.
NHS: "Trazodone is not suitable for some people. To make sure it's safe for you, check with your doctor before starting to take it"
The last UK poster about these drugs was unable to get either prescribed. But good luck, hopefully you have a helpful GP.
I tried Trazadone it definitely helped with sleep but unfortunately the very high doses needed for the antidepressant effect were not tolerable .Wasn't able to drive was falling asleep all the time .
Thank you all for your responses. Yes I am in the UK. As ever, very helpful. My GP has prescribed Trazadone though without any warnings - but I am holding off for the moment . The GP said I would need a consultant to prescribe Bupropion. to I am also considering consulting privately with Dr Mistry , sleep specialist and psychiatrist, based at the Royal London Hospital . Has anyone had any contact with him ? sleeppsychiatrist.london/
I live in Scotland and my GP refused my request to try Bupropion. I persisted and then referred it to the Community Pharmacy Team, who looked into it for him and promptly advised him to refuse it again, end of discussion.
Just yesterday, I had a telephone consultation with a mental health nurse who was covering the absence of the MHN attached to our GP practice. She noted that I'd given SSRIs a try over a period of time and we discussed the links with worsening RLS. She suggested trying a SNRI and was very open to my trying Trazodone . As she has to go through the practice to get approval for the prescription, at my suggestion she contacted the other GP (we only have two, in a large rural practice) and within an hour I'd had a call back saying she'd spoken to him, he understood the circumstances and a prescription would be written promptly.
For me, although I would say I have low mood the main reason for trying Trazodone is relief from physical symptoms such as poor sleep, sore throat and ears for no visible reason, headache, skin problems and hair loss, that may be due to years of low level anxiety. I've asked for a low dose as I tend to suffer side effects from any medication and I'll post again when I've given it a go as to whether it has helped.
I just dc’d Bupropion and my mood improved a little. But, Bupropion is the only AD that I’m aware of that doesn’t worsen RLS. However, it is generally “activating”, esp in the beginning so if you’re predisposed to anxiety, hyperactivity, etc, those may detract from any advantages.
Do you think the depression is related to disturbed sleep - through RLS-induced insomnia, PLMS, etc? Have you had a PSG or can you tape yourself sleeping?
Activating antidepressants may make insomnia, arousals worse, as it did in my case. Now I’m refocused back on sleeping better as the best way to combate depression and anxiety.
I think sleep deprivation symptoms in RLS/PLMD are more common than we think and providers often can make things worse by adding antidepressants that make quality sleep more difficult to achieve. Generally, I think it’s best to rule out problems with sleep quality before adding antidepressants to the mix. P.S. always taper off antidepressants very slowly to avoid withdrawal symptoms, some of which can be permanent. Don’t let your doctor convince you otherwise!
I’ve only just seen your post so I’m probably a little late with any advice.
However, like you I came off sertraline because of the terrible restless legs.
I took advice from this forum and asked my dr, who is very sympathetic, for Trazodone as I was still in desperate need of an antidepressant. She looked into it and agreed it was probably the best antidepressant for my situation.
It did not suit me one bit. My legs were as bad as ever. When I did some research I found there are cases where Trazodone does indeed have restless legs as a side effect.
I am now on Pregabalin 100mg morning and night. I started on 50 mg and that was not enough so it has just been increased. My legs are much better and I’m hoping after a little more time I’ll be sleeping better and the legs won’t bother me at all. I am also not as anxious.
I guess at the end of the day this RLS affects everyone differently and the medications affect everyone differently also.
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