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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Lumina on March 24, 2003, at 19:21:59
I started taking Effexor XR around six weeks ago, after trying almost every SSRI, plus Wellbutrin and Serezone. At 225 mgs, I've had virtually no side effects (but virtually no relief). 10 days ago, I suddenly developed Restless Leg Syndrome, most likely a result of the Effexor. I am weaning myself off the Effexor and am now down to 150 mgs. My PCP has referred me to a psychiatrist and prescribed Ambien to help me sleep through the RLS. Ambien works great, but only for four hours and, of course, only at night. The crawling sensation forces me to stand at work. My depression tells me to stay in bed; the RLS tells me to walk constantly. I still have two days until my appointment with the pyschiatrist and I am extremely uncomfortable. My doctor doesn't seem to know what to do, and fears this is a long-term condition awakened by the medication (I have a history of kicking, frequent myoclonic twitches, and teeth grinding). How long will this last and what can I do in the meantime?
Posted by Stan on March 24, 2003, at 21:35:18
In reply to Restless Leg Syndrome Relief, posted by Lumina on March 24, 2003, at 19:21:59
> I started taking Effexor XR around six weeks ago, after trying almost every SSRI, plus Wellbutrin and Serezone. At 225 mgs, I've had virtually no side effects (but virtually no relief). 10 days ago, I suddenly developed Restless Leg Syndrome, most likely a result of the Effexor. I am weaning myself off the Effexor and am now down to 150 mgs. My PCP has referred me to a psychiatrist and prescribed Ambien to help me sleep through the RLS. Ambien works great, but only for four hours and, of course, only at night. The crawling sensation forces me to stand at work. My depression tells me to stay in bed; the RLS tells me to walk constantly. I still have two days until my appointment with the pyschiatrist and I am extremely uncomfortable. My doctor doesn't seem to know what to do, and fears this is a long-term condition awakened by the medication (I have a history of kicking, frequent myoclonic twitches, and teeth grinding). How long will this last and what can I do in the meantime?
>>>>>>>>>>>>>>>>
hi lumina -- hopefully the psychiatrist you see will be familiar with RLS and be willing to let you try a dopamine agonist such as mirapex or requip (primarily used to treat parkinson's disease but quite effective for many RLS patients). here's a helpful website with lots of restless legs info: http://www.rlshelp.org
try to hang in there till your app't in a couple of days -- i don't know of any "quick fix" that will help you in the meantime that doesn't require a fresh Rx -- if your current doctor isn't familiar with the syndrome, chances are that he/she won't want to prescribe the drugs i mentioned above without researching them, and that would probably take at least a couple of days. i ran into the same problem when i was seeking relief from the same condition. good luck,
Stan
Posted by Krissy P on March 25, 2003, at 0:07:07
In reply to Restless Leg Syndrome Relief, posted by Lumina on March 24, 2003, at 19:21:59
Can you call your doc before the next 2 days until you see him???? Or ask if you can come in earlier as an emergency?
RLS isn't fun and I get it on Effexor too sometimes
Good luck:-)
> I started taking Effexor XR around six weeks ago, after trying almost every SSRI, plus Wellbutrin and Serezone. At 225 mgs, I've had virtually no side effects (but virtually no relief). 10 days ago, I suddenly developed Restless Leg Syndrome, most likely a result of the Effexor. I am weaning myself off the Effexor and am now down to 150 mgs. My PCP has referred me to a psychiatrist and prescribed Ambien to help me sleep through the RLS. Ambien works great, but only for four hours and, of course, only at night. The crawling sensation forces me to stand at work. My depression tells me to stay in bed; the RLS tells me to walk constantly. I still have two days until my appointment with the pyschiatrist and I am extremely uncomfortable. My doctor doesn't seem to know what to do, and fears this is a long-term condition awakened by the medication (I have a history of kicking, frequent myoclonic twitches, and teeth grinding). How long will this last and what can I do in the meantime?
Posted by Ame Sans Vie on March 25, 2003, at 12:56:53
In reply to Re: Restless Leg Syndrome Relief » Lumina, posted by Krissy P on March 25, 2003, at 0:07:07
Clonazepam is wonderful for RLS. It should work at least as well as the Ambien, but for much longer and without the uncontrollable urge to go to sleep.
Posted by Willow on March 28, 2003, at 7:48:34
In reply to Re: Restless Leg Syndrome Relief » Lumina, posted by Krissy P on March 25, 2003, at 0:07:07
Yes effexor dose changes can aggravate the symptoms, with time they do settle down. Mirapex I believe was the drug that did wonders for my rls, especially for daytime symtoms.
Presently I take codiene at night for it. I also take baclofen, and clonazepam. I had orginally tried the clonazepam for the nightime symptoms, which it didn't help, but I was pleasantly suprised by how much it helped with the physical symptoms caused by my anxiety.
If your gp or pyschiatrist aren't able to address your rls symptoms demand a referral to a sleep specialist.
BEST WISHES
Willow
Posted by sydney on March 28, 2003, at 11:33:35
In reply to Re: Restless Leg Syndrome Relief, posted by Willow on March 28, 2003, at 7:48:34
"Compared to placebo, gabapentin was associated with reduced symptoms on all rating scales. In addition, sleep studies showed a significantly reduced periodic leg movements during sleep (PLMS) index and improved sleep architecture (increased total sleep time, sleep efficiency, and slow wave sleep, and decreased stage 1 sleep). Patients whose symptoms included pain benefited most from gabapentin. The mean effective dosage at the end of the 6-week treatment period was 1,855 mg, although therapeutic effects were already observed at the end of week 4 (1,391 mg)."
Neurology 2002 Nov 26;59(10):1573-9
Given the controversy around the effectiveness of Neurontin/Gabapentin, I think it is important to note that the above results were from a double-blind, cross-over study.Another study abstract is found at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11706121&dopt=Abstract
There the authors conclude that "gabapentin provides a well-tolerated and effective treatment of idiopathic RLS."
Neurology 2001 Nov 13;57(9):1717-9
So...if the usual treatments (clonazepam, codeine, sleeping pills) weren't working, I would try Neurontin. I have a bit of akathasia related to risperdal, but have found Neurontin stops it cold. I note that Neurontin has zero side-effects for me but has really bothered others.
Posted by Lumina on March 28, 2003, at 15:56:30
In reply to Neurontin for Restless Leg Syndrome, posted by sydney on March 28, 2003, at 11:33:35
Thanks so much for the advice. I'm slowly coming off the Effexor. My session with the psychiatrist went well. He's prescribed Zyprexa to treat my mild bipolar tendencies (he feels anti-depressents are exacerbating the situation) and a short run of Clonazepam for the RLS. I was told that Neurontin would probably treat the symptoms, but not the underlying cause. The Zyprexa has knocked me out the last two nights, so I didn't take the Clonazepam. But according to my boyfriend it caused unusually violent outbursts (cursing, punching). I just started taking the Clonazepam today for the RLS, and hopefully that will deal with the myoclonic spasms and shakiness of the Effexor withdrawal as well. God, I sound like I'm falling apart, but really, I do feel much better. Thanks again.
Posted by Mama Bear on March 29, 2003, at 23:35:59
In reply to Restless Leg Syndrome Relief, posted by Lumina on March 24, 2003, at 19:21:59
Have you ever considered that your restless leg syndrome could and probably is caused by the medications that you are taking. You need to get a hold of the book called Your Drug May Be Your Problem. It is by a Doctor named Peter Breggin. This book can and will explain alot of what you have been going through. You can find a copy of this book on Amazon.com. You can also check out Dr. Breggins web site at www.breggin.com. Do your homework and you will find out for yourself that alot of these psychiatric medications cause more damage than they tell you about. They also cause symptoms that you are actually taking these drugs for in the first place. These types of drugs or neuroleptics can and do cause permanent brain damage and permanent movement disorders. These are called drug induced syndromes and are probably what you are going through right now. You most often do not see the symptoms or the damage that these medications have caused until you decrease or discontinue taking the offending medication. This is because these drugs mask the damage they are doing to you until you are no longer taking them or have cut back your dosage. Please check this stuff out. I did not and now my 5 year old little girl has suffered permanent brain damagae as a result of a neuroloptic called respirdal. Good Luck! Tammy
Posted by noa on March 30, 2003, at 9:00:41
In reply to Re: Restless Leg Syndrome Relief, posted by Mama Bear on March 29, 2003, at 23:35:59
OF course, I know my rls is caused by my meds. I don't need Breggin to tell me that. And I do not respect or trust his conclusions about medications. He is a one issue guy: anti-psychopharmocology.
I know my meds aren't perfect and have unwanted effects along with the desired effects. But the alternative is not an option for me. Untreated, depression damages the brain much more profoundly than any of the side effects can.
Posted by Willow on March 30, 2003, at 10:41:33
In reply to Re: Restless Leg Syndrome Relief » Mama Bear, posted by noa on March 30, 2003, at 9:00:41
Like Noa said, yes these drugs can cause movement disorders and other side effects. Mental illness, mood disorders aren't just a state of mind. I've spent a good part of my life trying to put my best foot forward, keeping my chin up, and using therapy. Despite a positive attitude I've been adversely affected by my condition.
I need these meds to function. Yes, they have negative physical effects, but the positive they do far out weighs any of the physical. I'm still me with a stiff neck, all my twitching, and other things. But not having control over my mind, I'm not the me you see.
Having said all that, I do believe that the meds are being prescribed too quickly. They aren't a cure for a bad mood etc.
Whistling Willow
Posted by juanantoniod on March 30, 2003, at 12:32:13
In reply to Shaky, but better, posted by Lumina on March 28, 2003, at 15:56:30
Dear Lumina,
I have extensive knowledge of RLS because my longtime companion had it. He developed it after starting dialysis for kidney failure. We went to several doctors before we found a sleep specialist who recognized and diagnosed the disorder. The doctor was actually motivated to go into medicine because his father suffered from RLS. With all due respect to the previous poster who cited the article which mentioned PLMS, they are not exactly the same, as RLS can occur while awake.
If you find that you still have RLS after your Effexor is out of your system, there is a variety of effective drugs that can be used to treat RLS. If you need help finding the articles which talk about treatments, I can probably help you find the information you need.
You would want to consult with a sleep specialist in your area who could prescribe the medication you need. Unfortunately, like mental illness, there is no cure-all drug that works for everyone. It's a matter of trial and error and, sometimes drugs work for a while then you must switch.
If I can be of any assistance to you, please let me know.
Take good care,
Antonio
Posted by Dr. Bob on March 30, 2003, at 16:54:56
In reply to Re: Restless Leg Syndrome Relief, posted by Mama Bear on March 29, 2003, at 23:35:59
> You need to get a hold of the book called Your Drug May Be Your Problem.
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
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