Brief Answer:
Likely to be drug induced adverse effects.

Detailed Answer:
Hi XXXX,

Welcome back!

I am really happy to know that you were able to handle the stress at workplace well.

Regarding the muscle pain in legs, the first possibility is that it may be an adverse effect of the medicines you are on. You were taking a statin (Lipitor) previously. Muscle aches are a common side effect of statin group of drugs. If you're still taking one, you can discuss with your physician and stop it for a few weeks to see if muscle ache improves or not.

You have mentioned that you have pain at night. That suggests a possibility of Restless Legs Syndrome (RLS). RLS is characterized by a strong urge to move the legs. This urge often, but not always, occurs with unpleasant feelings in legs, like itching, burning, cramps, pain etc. These symptoms either start or get worse when one is inactive. The urge to move increases when one is sitting still or lying down and resting. Movement, especially walking, helps relieve the unpleasant feelings. The symptoms of RLS usually start or get worse in the evening or at night. If what you are experiencing appears to be similar to the symptoms of RLS, then we need to find out the cause for this. Many drugs can cause RLS, including Cipralex. Bupropion is considered to be safe in people with RLS.

A third possibility is dehydration and resulting imbalance in serum electrolytes. This can also cause pain in the calves.

Apart from these, there are many causes for leg pains like neuropathy, kidney disease, thyroid disease etc. But since you are not having any other symptoms and moreover, since you get regular blood tests done and get checked up by a physician, I am not concerned about these possibilities.

I have a feeling that your problem is due to adverse effects and will get better when the offending agent is removed. Do let me know what you think about this.

Best wishes.

Dr Preeti Parakh
MD Psychiatry

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