Mental Health Medication and RLS

I didn’t know that selective serotonin reuptake inhibitors (SSRIs) and other medications could make restless legs syndrome worse until I started reading the articles on this website about restless legs.

I was on an SSRI, Lexapro, but didn’t necessarily think there was a connection, despite what I read.

Anxiety spikes and 'rescue' medications

Over the summer of 2020, my anxiety spiked due to stress. It was 2020, after all. My nurse prescriber decided to give me several “rescue” medications: propranolol, Klonopin, and Xanax. I didn’t take them all at once (because that would be a bad choice), and the Klonopin and Xanax are addictive, so I didn’t take them all the time, but these medications helped me with my anxiety and also helped me get some much-needed sleep.

Double whammy: insomnia and anxiety

When I continued having anxiety attacks, my prescriber decided to switch me to another drug that might work better. It didn’t work for me. I had inexplicable insomnia, meaning I would wake up in the middle of the night for seemingly no reason, not that something was bothering me, and would be awake for hours.

My anxiety wasn’t better, either, though this could be due to the lack of sleep. She took me off all drugs and told me to take the “rescue” meds as needed until I “dried out.” I had a good week and thought that maybe I didn’t need an SSRI.

Working with my doctor to find a solution

Then I had a bad week. There were several external stressors: issues with my ex, my kids had a hard week, and I was working with several deadlines that seemed overwhelming. Plus, I realized that, perhaps, I did need more help with my mental health than the “rescue” medications could give.

I went back to my prescriber and she did a genetic test on me to determine what meds might work better than others.

'I have RLS. Does that matter?'

Just as she was about to end our call, I said, “Oh wait! One other thing! I have restless legs syndrome...if that matters?”

She looked confused. “You have restless legs syndrome?”

“Does that matter?”

“Yes.” She said, matter-of-factly. “How’s your iron?”

“I don’t know...”

“Do you take magnesium?”

“No.”

She sighed. “Start taking magnesium. I’m going to order labs to check your iron. And we are going to try an SSRI, but keep me posted.”

Why didn't I mention RLS sooner?

She scheduled me for another visit 2 weeks after starting the new medication. I should have mentioned the restless legs sooner, but I honestly didn’t know it mattered.

I knew from reading other articles that magnesium is something that could have helped me. I even took it with success during pregnancy. But why didn’t I?

My sleep and my restless legs are feeling better

Off of the medications that caused me insomnia, I did start to sleep a lot better. Not only was I falling asleep and staying asleep, but my restless legs were markedly better. It hasn’t been long enough for me to say that the new medication is going to do the trick at keeping my anxiety at bay while not making my restless legs worse, but I’m feeling hopeful to try.

Your health history is important

Always tell your providers your health history, even when it might not be relevant. When it comes to mental health, you may need to have a conversation about the hierarchy of needs.

For me, I needed help with my anxiety more than I needed help for my restless legs. However, there are medications that potentially work with my particular brain chemistry that can help with anxiety and keep my restless legs from getting worse.