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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taking ropinirole for Restless Leg Syndrome and prozec for bouts of depression. Could antidepressant contribute to RLS?

Answered by
Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

Posted on Thu, 5 Dec 2013 in General Health
Question: I am a 68 year old male and I have been diagnosed with Restless Leg Sympton. I have been taking a 3mg tablet of Ropinirole, generic for Requip at bedtime. Since I started taking this medication it seems to have gotten worse. I now start noticing the restless legs earlier in the afternoon. I also suffer from periodic bouts of depression. I have had it for years and I take an antidepressant regularly for this. Right now I taking 80mg of Prozac a day, 2 in morning and 2 in evening. I am starting to experience depression with the RLS. Could my antidepressant be contributing to my RLS. I have been taking Prozac for a very long time. I am getting discouraged about this. Is there an effective treatment for what I am experiencing?
Answered by Dr. Shafi Ullah Khan 2 hours later
Brief Answer: RLS needs Management,Psychiatrist for Depression Detailed Answer: Hello there Sir! I have been through your query and I believe you are not getting enough treatment for it. If you are not getting symptoms relieved by ropinirole you can increase the dose upto 4 mg a day or you can change medications and select other from the list I provided down there after discussing with your neurologist. Before going any further discussing your treatment I think you may stop prozac in the evening. Morning dose is enough. Discuss with your doctor about it. Antidepressants add to your leg's restlessness. So no prozac in the evening, just morning. Instead you can use Klonopin (clonazepam) in the evening. Lets talk the treatment options. You need to pick one from every class. A-Antiparkinson Agents, Dopamine Agonists Pramipexole (Mirapex, Mirapex ER) Ropinirole (Requip, Requip XL) Levodopa with carbidopa (Sinemet, Parcopa) Bromocriptine mesylate (Parlodel, Cycloset) Rotigotine (Neupro) B-Anxiolytics, Benzodiazepines Clonazepam (Klonopin) C-Opioid Analgesics Low Potency( codein) High potency if refractory to low one.( oxycodone hydrochloride, methadone hydrochloride, and levorphanol tartrate) care for addiction. D-Anticonvulsants, Other Gabapentin Enacarbil (Horizant) Gabapentin (Neurontin) Pregabalin (Lyrica) E-Alpha2-Adrenergic Agonists Clonidine hydrochloride (Catapres, Kapvay, Nexiclon XR) F-Iron Salt Iron sucrose (Venofer) take 325mg iron 60 mins before meal with 250 mg Vitamin C supplements. G- Herbal Remedy -Yokukansan Anecdotal evidence from Japan suggests that yokukansan (an herbal remedy) is effective in the treatment of RLS H-Oral corticosteroids Deltacortil (prednisone) But you need a close monitoring by your Neurologist for RLS. Mean while see the Psychiatrist for Depressive sympoms. Sign up to Group therapies, vocational and recreational therapies. And I am sure you will feel better. Just a prozac is not an answer. Hope I was of some help. If you have any more queries please feel free to ask other wise kindly close the discussion and rate the answer as per your experience. I wish you very good luck and take some very good care of yourself. Regards Dr S Khan
Above answer was peer-reviewed by : Dr. Vaishalee Punj

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