RLS or Akathisia or both?: Wow! I just... - Restless Legs Syn...

Restless Legs Syndrome

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RLS or Akathisia or both?

Clingonmf profile image
21 Replies

Wow! I just wrote a bunch of stuff but it disappeared. That's my luck with computers. I'll try again. I was diagnosed as having RLS in December '21 but now I think I have akathisia. My neurologist doesn't think so. He says akathisia is rare. I didn't know anything about akathisia until about three weeks ago. When I saw the definition my jaw hit the floor. It seemed to describe me to a "T". Now I am trying to learn as much as possible about it. I know it gets misdiagnosed as RLS a lot. I was on antidepressants and antipsychotics for 41 years. I tried to quit taking them in December 21 but had to go back on Zoloft at a low dose. I did quit Wellbutrin and Abilify and have been messed up ever since. I see where Abilify is strongly implicated in causing akathisia. My neurologist has me on Ropinirole and it is causing me some serious problems. Now I am trying to titrate off that and am worried about the RLS and other symptoms getting worse. Does anyone out there have experience and/or knowledge about akathisia/RLS and dopamine agonists?

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Clingonmf
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21 Replies
SueJohnson profile image
SueJohnson

There are two main difference between RLS and akathisia. With akathisia it doesn't get worse at night and it is helped by dopamine antagonists instead of dopamine agonists like ropinirole. How does this fit your symptoms? Zoloft by the way makes RLS worse.

Clingonmf profile image
Clingonmf in reply toSueJohnson

Thank you for your caring reply. I am totally new to this whole social networking thing and I have a hard time typing. I am very slow.

SkyCop profile image
SkyCop

At age 20 I was mis- diagnosed with akathesia after I had an anti nausea medication called compezine during surgery. I woke up wanting to just crawl out of my skin- literally unzip myself and crawl out. I was twitching & thrashing and the psychological angst was beyond description. At the time no one knew it was the medication that caused it.... or it's link to RLS. It took over 2 weeks for it to get out of my system. One of the worst experiences of my life. When I was finally correctly diagnosed with RLS I found out that anti nausea, anti psychotic & anti depressants are culprits in worsening RLS symptoms. What no one understands is why it took so long for it to clear my system. My grandpa,dad, brother, sister, & husband are physicians and all say compezine should have been long gone but they are not the ones experiencing what we feel. What I learned is medication can cause akathesia symptoms in RLS patients and it takes much longer to clear the system of meds that they tell you. There might be no way for you to get a clear diagnosis without going off all the culprit meds for a while. For me 2 weeks for just 1 dose of compezine.... If you have more in your system it may take longer?? I dunno. I do know what it's like to go off meds though and it's hell. I take ropinerol for RLS but it's famous for augmentation so once in a while I 30 day purge to reset the cycle and it's hell.... Wouldn't wish it on anyone.

Joolsg profile image
Joolsg in reply toSkyCop

Why put yourself through that hell for 30 days every so often? Why not get off Ropinirole completely and onto better meds and find a knowledgeable doctor who will continue iron infusions so your serum ferritin stays above 100 & your RLS is controlled.Pregabalin/gabapentin are now first line meds after iron infusions.

The Mayo algorithm sets it all out.

SkyCop profile image
SkyCop in reply toJoolsg

I've been on pregabalin, gabapentin, etc... But didn't work. Ropinerol & iron infusions are only thing that have worked for me. Would love to find a Dr who will listen to the evidence. I feel like the higher dose of ropinerol he put me on recently is causing some weird obsessive thoughts and I hate feeling like this. I live in NY and if anyone on this thread knows a doc who will do infusion for low but not quite anemic levels please let me know! :)

Iron blood work showing low but not quite anemic
Joolsg profile image
Joolsg in reply toSkyCop

Were you on gabapentin/pregabalin while still taking Ropinirole? If so, they wouldn't work. They are effective after you've been off Ropinirole for about a month.Ropinirole can cause serious Impulse Control.Disorder ( gambling, shopping, overeating, OCD). Sounds like you could be experiencing that.

This is a UK based website but hopefully some of our US visitors will know someone in NY.

I know Dr. Glen Brooks at the Ketamine Clinic would help get you off Ropinirole but not sure if he's familiar with infusions.

You need serum ferritin, the most important indicator for RLS.

Have you joined rls.org? They have Centres of Excellence and local help groups.

Clingonmf profile image
Clingonmf in reply toSkyCop

Thank you for your caring reply. I am totally new to this whole social networking thing and I type very slowly.

Joolsg profile image
Joolsg

If you are susceptible to RLS, most anti depressants and anti psychotics will trigger/ make it much worse. Some people find that they are free of RLS after stopping their anti depressants/anti psychotics so it's difficult to know in your case.Clearly, you need to weigh up the RLS versus the mental health and ensure you see someone who can balance both.

There are RLS safe anti depressants (wellbutrin is one) but they don't work for everyone.

I hope you can find something that helps your depression and doesn't worsen RLS.

How long have you been on Ropinirole? If longer than a few months, then reduce slowly to avoid severe withdrawal. Getting off Ropinirole can be hellish with very intense RLS and little sleep for weeks.

Clingonmf profile image
Clingonmf in reply toJoolsg

Thank you for your caring reply. I am totally new at this whole networking thing and I type very slowly. I have been on Ropinirole for one year now and I am experienceing impulse control disorder problems and daytime sleepiness. I have reduced my dose as of four days ago and am planning on getting off of Ropinirole but my neurologist wants to try me on the Neupro patch. I am learning such bad things about most of the medications that I am leaning towards getting off everything.

Joolsg profile image
Joolsg in reply toClingonmf

Neupro patch is another dopamine agonist and will quickly cause augmentation again AND will worsen the impulse Control. There have been many class actions in the USA for ICD so mention that to your neurologist.Reduce slowly and try to find a better neurologist who will consider all your meds and help you through withdrawal.

Definitely join rls.org to find a doctor near you.

SueJohnson profile image
SueJohnson

Trazodone is a safe antidepressant for RLS.

Clingonmf profile image
Clingonmf in reply toSueJohnson

Thank you Sue Johnson. I will look into that.

Yecam1949 profile image
Yecam1949

I have some kind of movement disorder that is undiagnosed. I am seeing that all kinds of conditions including movement disorders, insomnia, depression, mental illness, skin problems, thyroid issues, blood pressure, and type II diabetes, and others is being cured with carnivore and ketogenic diets. I am seeing improvement in my cptsd, sleep, mental cognition, and moods. I have also eliminated pain and stiffness from arthritis. God gave us self healing bodies. We blew it with poor nutrition and lifestyle choices and by believing what we have been told by the medical community. Go to you tube and do some web searches. Most of conventional medicine has been debunked. I am grateful that covid did teach us one thing. Our government and all its entities are not to be trusted. We must take responsibility for our own health.

in reply toYecam1949

It’s not conventional medicine that’s been debunked, it’s these fad diets that have been. Our ancestors were piss poor hunters and meat came from small rodent like animals. We were scavengers eating every imaginable plant, insect and soil organism - and we’re talking about for millions of years. So these fad diets are bucking up against millions of years of evolution. AND, using fire for cooking is a fairly recent event on the evolutionary timeline and probably contributed to the downfall of our health almost as much as the discovery of bread. Cooked red meat is NOT healthy. And that is true for probably any animal protein. Cooking removes the delicate enzymes that help us digest this complex food source. What we don’t breakdown and digest becomes just another toxin in our body.

Covid didn’t teach us that we can’t trust government it taught us about the dark underbelly of society and people who will follow the word of cult figures (think Qanon) over the scientific research of men and women who have dedicated their lives to treating infectious diseases.

Good luck with that diet. Hope your kidneys are in good shape to withstand the onslaught of meat byproducts.

Oregonmike profile image
Oregonmike in reply to

could not disagree more. Israelites have been cooking with fire for 6k plus. There are no known detrimental effects of steaming vegetables or boiling meat, etc. your data is simply flawed.

It’s all about knowing which fruits veggies are raw and which are cooked best.

Activity and large muscle exercise is key.

Meat should not be eaten raw - ever. Just a matter of how best to cook.

in reply toOregonmike

I’m not speaking to cooked vegetables. I don’t think 6000 years is long enough for an adaptation to occur. Besides, I believe our ancestors have been using fire for cooking for closer to 80,000 years. So we might be getting closer to an adaptation. Life eats life, but Mother Nature built us to eat that life raw. If something were to eat us, there are very specific enzymes contained in our tissues that will help that creature digest us. By eating us raw there will be very little strain put on its pancreas and other organs. Food eaten raw essentially digests itself. It’s practically a vacation for the pancreas. That’s the ideal.

Oregonmike profile image
Oregonmike in reply to

I appreciate your return

God created us originally to be vegetarian- but we fell in the garden.

So we eat meat- and plants

I’m omnivorous- because I’m of fallen Adam.

Until Christ returns- I’ll be this way.

Can we eat raw flesh? Yes.

Should we? Nope.

I do like your line of reasoning however.

Thank you for contributing to a fascinating topic.

I mean that

in reply toOregonmike

Isn’t that a fairy tale? However, I HATE that life eats life. I’ll have a few choice words for the Creator when I’m reunited.

in reply toOregonmike

If you don’t like this story better than the Adam & Eve one, I’ll eat my words (no pun intended). Christ has probably already returned several times, as we all have. m.youtube.com/watch?v=R8o2r...

SueJohnson profile image
SueJohnson

If you want the names of some doctors from RLS.org, let me know where you live and I can check for you.

Oregonmike profile image
Oregonmike

true words

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