RLS and psychiatric medications

This comes up often and it is genuinely difficult. A number of psychiatric medications, particularly many antidepressants, can trigger or worsen restless legs. That is hard when the medication is also helping something that matters a great deal.

Most important: do not stop a psychiatric medication on your own. Stopping antidepressants abruptly can cause serious problems. The goal here is a better conversation with your prescriber, not a solo change.

Which medications are involved

Many of the common antidepressants that increase serotonin are the ones most often linked to worse RLS. Some antidepressants are generally considered less likely to aggravate it, and a few are sometimes used with sleep in mind. Because this varies so much from person to person and drug to drug, the specifics belong with the doctor who manages your mental health care.

Weighing benefit against symptoms

The answer is rarely to simply stop the medication. More often it is a careful weighing:

• How much is the medication helping the condition it is prescribed for?
• How much is it worsening the RLS, and can the RLS be managed another way, such as iron or an alpha-2-delta ligand, instead?
• Is there an alternative in the same category that is easier on the legs?

Coordinating your care

If different clinicians handle your mental health and your RLS, make sure they know about each other's plans. A decision that is good for one and blind to the other rarely works out. Members who have navigated the same overlap can help you think it through.