RLS virtually disappeared after three months off Prozac. But my OCD is back and back with a vengeance. What now?

[restlessthruprozac]

I am getting back on Prozac again and this thought really terrifies me. What if the RLS shows up again? I'm already experiencing signs of RLS.

Ferritin is low, so is B12. Would increasing them alone suffice?

[ChrisColumbus]

Welcome to the forum.

Increasing ferritin and B12 may certainly help to improve RLS symptoms - have you had a recent fasting full panel iron test to measure ferritin and transferrin saturation (TSAT) and if so what were the results?

But are you on other medications as many can trigger/exacerbate RLS. See this list for example:

rls-uk.org/medications-avoid

I see that you mention gabapentin in your profile: are you still taking this, is it for RLS, how much are you taking and when? And have you previously taken other medications for RLS like the dopamine agonists - pramipexole (Mirapex), ropinirole (Requip), rotigotine (Neupro) - which I note have been/are prescribed in India for RLS, and which make RLS worse in the long run?

Fluoxetine (Prozac) makes RLS worse for most, as do the other SSRI antidepressants generally used in drug treatment of OCD. Trazodone or bupropion (Wellbutrin) are antidepressants generally regarded as safer for RLS, but they may be less effective against OCD - I've certainly seen that said about trazodone. And I don't know whether these are available in India...

[restlessthruprozac in reply to ChrisColumbus]

That's right. Been on DAs before but as I said going off Prozac and some three months later I no longer has symptoms. Now I'm back on them and bam! RLS is back.

I feel so lost. My OCD is quite bad to leave untreated without meds.

[SueJohnson]

Welcome to the forum. You will find lots of help, support and understanding here.

You might want to try Inositol or myo-inositol which is OTC for your OCD.

You list gabapentin on your profile. Are you taking it? Does it help your RLS?

To elaborate on what Chris said. Have you had your ferritin checked? If so, what was it? Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. This is the first thing a doctor should do. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice.

Some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium(salt), foods that cause inflammation, ice cream, eating late at night, estrogen without progesterone and sometimes even with it, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, eating late at night, stress and vigorous exercise. It is a good idea to keep a food diary to see if any food make your RLS worse.

Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennel, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, CBD, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices like therapulse, using a standing desk, listening to music, meditation and yoga.

Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute. I have a list of more than 300 medicines and OTC supplements that make RLS worse and have safe alternatives for most of them.

[restlessthruprozac in reply to SueJohnson]

Thanks for the comment.

What's a medication that's effective for OCD but RLS safe? It seems like Trazadone and Wellbutrin aren't that effective when it comes to OCD.

[SueJohnson in reply to restlessthruprozac]

There really isn't. N-acetylcysteine (NAC) which is OTC in many countries may help and there is psilocybin (magic mushrooms). Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP), is highly effective for OCD .

[Joolsg]

Anti depressants like Prozac are known triggers for RLS.

Follow Chris Columbus and Sue Johnson advice. Raise your serum ferritin above 200 ideally. Professor Toby Richards, who spoke at our AGM las year on the benefits of iron infusions for RLS, also mentioned that raising iron levels improves many case of anxiety and thyroid disease. So raising iron might also alleviate your OCD.

[Hectorsmum2]

If your b12 is low there must be a reason. Are you vegi or vegan, do you have thyroid issues or are you prescribed proton pump inhibiters. If not you might have pernicious anemia and need injections. Best post on pernicious anemia forum in health unlocked for more expert advice. Increasing B12 might well help restless legs and maybe OCD.