Could rebound from Kratom worsen RLS symptoms?

[AmazedAnt]

I've been using Kratom for a bit over a year now since coming of ropinirole and stopping gabapentenoids as well - it has helped impressively.

However, I've had to increase from 2-3 grams at night to around 4-5 grams to get adequate relief. My RLS has worsened , but I am also taking sertraline / zoloft and am fully aware that its probably contributing to the worsening.

I'm also wondering if some of the increase in symptoms could be coming from a rebound/withdrawal effect of being off of kratom for 24 hours until I dose again?

Any ideas, experiences or references would be greatly appreciated

[SleeplessinMO]

I would think that the withdrawal from Kratom could definitely cause that. I know that my opiate medication can cause my RLS to get worse if I forget my pain meds. Have you checked drug interactions with Kratom? You never know with these medications, if they can interact and cause worse outcomes than you might think.

[AmazedAnt in reply to SleeplessinMO]

Thank you Sleepless! It does appear to interact with antidepressants and anxiolytic meds - I'm using both.. Moderate amounts of alcohol and cannabis as well 😬

I've been open about using it, as well as cannabis and alcohol with my entire medical team, they shared concerns about the consistency / reliability of it as it isn't regulated, but didn't mention anything with interactions.

[Joolsg]

Kratom is known to cause tolerance very quickly. You end up taking higher and higher doses.It is addictive. I only ever recommend it to get through dopamine agonists withdrawal. Not as long term treatment.

And if you miss a dose you will get serious withdrawal symptoms similar to opioid withdrawals. The main symptom will be increased RLS.

So- I would see a knowledgeable specialist and switch to a long term opioid like methadone or Buprenorphine.

Everyone I know on here who has tried kratom long term ends up taking higher and higher doses and ends up in a difficult situation.

[AmazedAnt in reply to Joolsg]

Thanks Joolsg,

I am seeing my neurologist / RLS specialist at Penn medicine next week. Will review what has happened and hopefully he'll be open to switching to an opioid 🤞🤞

[Joolsg in reply to AmazedAnt]

Good luck. Buprenorphine can be used to get you off kratom.Sublingual pills are more common here in UK and we start at 0.2mg. The USA smallest dose is 2mg so patients tend to use the buccal film which is easier to cut into smaller strips.

Make sure the neurologist you see is familiar with the latest American Academy of Sleep Medicine Guidance released in January 2025.

[AmazedAnt in reply to Joolsg]

Thank you.. Just looked it up , here's a link:

aasm.org/new-guideline-prov...

[TheDoDahMan]

I used kratom for several months, in ever-increasing doses (from 3 to 30 grams per day) to great advantage in ability to sleep. Once I found Dr. Buchfuhrer and he put me on 10mg per day of methadone, I no longer needed kratom and have not had any tolerance problems with methadone like I had with kratom. Nonetheless, I felt quite happy to have had the kratom until I was able to get on the low-dose opioid.

[AmazedAnt in reply to TheDoDahMan]

Thanks DoDahMan! It has worked better than anything I've tried, hoping my neurologist is open to methadone/buprenophine.. I'm worried its going to be a long project, but will go prepared with some of the scientific literature / studies on opoids for severe RLS.

I tried to get in at Johns Hopkins RLS quality care center, but they don't allow from out of state. Next closest quality care center is in Pittsburgh, which is approx 300 miles away. I've contacted them and I can get treatment there.. Just hoping I can get help closer

[LotteM]

I agree with others that is can be the kratom. It helps to rotate strains, but in the long run you may need some reset. Hopefully you can get a registered alternative.

[AmazedAnt in reply to LotteM]

Thank you LotteM! I've been rotating between red bali, red borneo and red meng-da. If my neurologist is hesitant on prescribing opiates, I'm thinking of going on breaks to reset tolerance and using the dreaded ropinirole + pregabalin for those nights.

🤞🤞

[SueJohnson in reply to AmazedAnt]

That's the last thing you want to do. You would quickly augment on ropinirole again and pregabalin doesn't help when you are on ropinirole.

[AmazedAnt in reply to SueJohnson]

Thanks Sue! 🤞hope my doctor is open to methadone/buprenorphine.. Will post details after I see him 4/15

[LotteM in reply to AmazedAnt]

If you can access the ropinirole AND make sure you stay on the lowest effective dose for as short a time as possible.

Please do a search for “kratom” on this forum. I think people have written about their experience with escalating doses and resetting that by stopping the kratom for a while. You may find some epxeriences as to what amount of time was successful.