so folks looking for advice, suggestions etc as having a tough time these days. Now been taking buprenorphine since June and reduced gabapentin as it makes me feel dizzy and unstable. Last dose of pramipexole was June. Get occasional break throughs of RLS but either get up and have a hot drink, putter a bit and it settles or take a 1/4 tablet of a 2mg buprenorphine. My regular dosage of buprenorphine is 1/4 tablet around 5-6 pm then 1/4 tablet around 9pm. My struggle these days is anxiety and depression. Last night while no rls, I just couldn’t sleep so got up. Couple hours later I went back to bed and slept fine. I felt good last night, calm and positive and relaxed. This morning woke feeling incredibly anxious, heart racing fearful, and then just wanting to scream or cry. Struggling with this everyday, and getting more exhausted trying to stop this. It is like I find little joy in life. Is this buprenorphine? Any suggestions? I walk everyday now, trying to raise my heart rate, see something beautiful good in my day, but feel a huge sense of hopelessness and sadness all the time.
depression and anxiety: so folks... - Restless Legs Syn...
depression and anxiety
Yes anxiety and depression are common side effects of buprenorphine. Buspar (Buspirone) is good for anxiety. Trazodone helps both anxiety and depression as well as insomnia. Wellbutrin is also good for depression.
I had severe anxiety/panic attacks on Buprenorphine. Dr Buchfuhrer advised me to add low dose pregabalin as it is sedating and counters the opioid. It worked at low dose for me. And reduces the racing heart.I also take 10mg cetirizine which really helps the sweats.
I'm interested in the cetirizine for sweating. Do you mean the antihistamine? I'm assuming you take it at night? What brand do you use ?
I buy the cheapest brand on Amazon. Yes the anti histamine.But I've also noticed that as I recently reduced pregabalin from 25mg to 6mg, my daytime head sweats have increased.
Pregabalin has been used to reduce menopausal sweats/hot flushes. I may increase to 25mg again.
If you are having any insomnia due to the buprenorphine the resulting sleep deprivation can lead to mental health issues. If that's not the case then you may need to start by trying the meds Sue mentioned. I would try Wellbutrin last as it can disrupt the sleep process as well. If you need a more traditional SSRI or SSNI you may find that your buprenorphine may cover any additional RLS symptoms that they would cause.
You could also try vortioxetine. It's a newer antipressant. During my trial of this medication I did not notice any additional RLS issues and it did seem to help depression. Unfortunately, I was unable to continue taking it as it caused agitation that was not tolerable. But you may find a different experience.
It get that it really sucks to have to take additional medication to treat side effects of the original medication. And who knows what the new may medication bring about.
Hit me up if need any support on dealing with the RLS/Depression/Anxiety combo. I've been trying to tackle this monster most of my adult life. It can be very frustrating.
Thank you for this. I am going to discuss options with my neurologist. I am going to do a two week diary without making any changes right now to see if I can identify any triggers. I know I have to be really careful about sugar and eating desserts etc. I realised I also need to get a blood test done for my thyroid levels to make sure those are steady....then take some deep breaths and try not to bloody overthink everything......deep breath and let go and it is still way better than RLS. Thank you so much for the support.
so true, I have similar, low mood, low energy, on methadone, but it is so important for me to no longer be dealing with the awful RL that I remind myself and then I feel a bit better.
I think it's really important that you are appreciating the improvements with RLS and are able to step back a little from the current issues which are still difficult to cope with - lack of sleep is hard whatever the cause. I have found meditation has helped me to reduce anxiety and accept what comes, I have had difficult back issues as well as RLS and I found that I was fighting my situation and making it worse by imagining the worst case scenarios. Over the years I have learned to appreciate all the good things, from that first good coffee of the day and the company of friends and family and I am fortunate that some things have healed and improved so while I still have issues to deal with they have a much smaller impact on my life. There is a saying that what you resist, persists and I have definitely found that to be true. If you fight it you are in a permanent state of anxiety and conflict which doesn't help in any way. All the best
Thank you for your wise words, they have made me check in with myself and see how my thinking maybe adding to hiw I am feeling. I have to remember that feelings are fluid and can change. I have come a long way with managing rls and getting off pramipexole and I am going to make a point of celebrating and really acknowledging this.
Absolutely! Things do change which means you don’t have to accept that it will always be like this. It takes time for withdrawal from DAs to settle. I still get up 3 times a night or more and have to walk around but I’ve stopped fighting it and just (slightly wearily) get out of bed, stay warm and walk gently for 20-30 minutes until I can sleep again. Just that change of not getting angry has helped and most nights I get just about enough sleep eventually. And I have good weeks and bad weeks and enjoy the good and breath deeply during the bad. Good luck.
I was interested to read what ziggypiggy said about vortioxetine. I started Buprenorphine in May this year but had been on vortioxetine for a couple of years beforehand to deal with the depression caused by sleep deprivation.
Now that my RLS is under control (I take 0.4mg once at 8pm and occasionally another 0.1mg for breakthrough symptoms), I had been planning to taper off the vortioxetine. My neurologist just told me to stay on it at 20mg daily, mainly so as not to risk disrupting my slowly improving sleep pattterns.
Reading your post (and Joolsg ) makes me realise that the vortioxetine is probably doing a very good job of covering any anxiety/depression caused by the Buprenorphine. I haven't once had a panic or anxiety attack since starting, and generally feel pretty positive because I'm finally getting some sleep.
I'd definitely confirm that vortioxetine does not trigger RLS, and I've tried most antidepressants out there. Maybe one to discuss with your doctor as you could find it resolves the problem and allows you to continue with the life-saving Buprenorphine.
Awesome to hear. Sounds like you've found a sweet spot with the meds. Ride that wave.
I don’t have any medication advise, just wanted to add that major depression can happen for a very long time after withdrawing from DA’s. It’s the main symptom of DAWS.
Depression, anxiety and RLS can be caused by the same thing, your diet. Foods in your diet can cause inflammation in your whole body, including the nerves and inflamed nerves are hypersensitive and don't work optimally leading to all sorts of problems from RLS to mental problems. youtu.be/tvvvLkth5Q0?si=B1i...
Hi,This is happening first time? Ever happened before medication?
You might want to hear my master dr Barry Krakow on sleep disorder. Last newsletter from yesterday.
ALL the best
open.spotify.com/episode/3g...
This is a great podcast - give it a listen for sleep issues!
I am also dealing with the aftermath of DAs. I wake up every morning with anxiety and depression. After my experience with DAs I don't want to take medication for this. I feel it always comes with some price to pay. To set myself right I do breathwork every morning and then I either take a cold shower or do a cold plunge. Every morning I wake up in disbelief that this will work. But it works for me every single time. If you want I can recommend a guided breathing session on youtube. I understand that most people would like some medical solution, but I thought I should tell about a possible alternative.
Yes please, will you please post the YouTube video?
Hi Merny5, I am following this guy youtube.com/@Timvandervliet He has very easy to understand sessions like this one youtube.com/watch?v=yCq0uGZ... His sessions also do not come with any bullshit or dogma or are about him as an instructor like some "gurus" in the breathwork world.
According to Andrew Huberman - cold water exposure is the best activator for increasing dopamine.
so sorry to hear you feel this way. It sounds like I’m on the same path as you. I am stopping my Mirapex and sticking to Buprenorphine. However, I take about 1/8 in the morning (I also have chronic pain so it helps for that & RLS) and an 1/8 before bed. I notice a direct mood lift from the am dose.
I also started playing pickleball which has greatly lifted my mood. Best of luck to you.
Others have given you drug suggestions. I would suggest mindfulness practice.It greatly supports my mental health.Good luck.
It could be caused from the DA withdrawal, that was only 4 months ago.
Hello, sorry to hear about your issues with depression. It resonated with me, because I often wake up feeling very depressed, even if I've had a reasonable sleep, no major RLS problems, and no other particular worries. Once I'm up and about it usually passes quite quickly, but it's a horrible feeling when you're lying in bed. It seems to be a recognised condition, which could be linked to raised cortisol levels or inflammation. I do try to get up and get a burst of early morning light: even on a cloudy day, looking out of the window and into the distance, with a cup of tea or coffee (rather than staring at the computer) does seem to help. Your walks will also help. I just try to remind myself that it's just my body or brain making certain adjustments, that there is nothing really wrong, and that it will pass if I get up and get busy. Of course, if you feel that you have a serious depressive condition, then you will need to get further advice, but I hope that you can find a way to cope with it.
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