Does Trazodone Cause Restless Legs Syndrome?

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Restless Leg Syndrome, known as RLS, is a neurological disorder which produces uncomfortable sensations in the legs and occasionally in other parts of the body, when the sufferer is at rest or overly tired. Some medications can exacerbate or even cause restless leg symptoms.

Types of RLS

  • RLS is categorized as either primary or secondary.

    Primary RLS is idiopathic, meaning that it is not the result of any other medical condition and is not a side effect of any medication.

    Secondary RLS is the result of a medical condition, or develops as a result of a medication that's being taken. Medications that can contribute include some antihistamines, antiemetics and antidepressants.

Trazodone and RLS

  • Trazodone is a tetracyclic antidepressant with hypnotic and anxiolytic properties. This older style antidepressant has generally been superseded by more modern drugs, in particular SSRIs (serotonin reuptake inhibitors). Nonetheless, trazodone it is still widely prescribed, though its more frequent purpose is to combat insomnia. Trazodone is generally considered an "RLS friendly" antidepressant, which is well tolerated by most RLS patients.

    For some people, trazodone actually even decreases RLS symptoms. This could be because it is effective for periodic limb movement disorder (PLMD), a condition that many RLS sufferers share. By reducing PLMD incidents, trazodone may allow for more restlful sleep. That means that RLS patients are less frequently overtired during the day, resulting in decreased symptoms.

    Other sufferers report that trazodone has the opposite effect, increasing RLS symptoms and causing next-day drowsiness.

    RLS patients should use caution when trazodone is prescribed, observing its effect and working closely with a physician. Because of differences in brain chemistry from one individual to another, the effects of trazodone can vary widely.

Medications that Can Help RLS

  • The most frequently prescribed medications for RLS are dopamine agonists like ropinerole (Requip) and pramipexole (Mirapex). Benzodiazepines like clonezepam and temazepam are prescribed for individuals with more sporadic cases of RLS, because they can be taken on an as-needed basis. Opioids are sometimes recommended, particularly for individuals who experience pain as a result of RLS.

Medications that Contribute to RLS

  • Some anti-nausea, anti-seizure and antihistamine drugs can contribute to RLS, as can various anti-psychotics. While many individuals find that antidepressants of various types can alleviate RLS symptoms, others find that these medications increase RLS.

Communicate With Your Doctor

  • Ask your doctor if trazodone for depression or sleep issues is right for you. A sleep study may be ordered to determine whether you have PLMD. Some RLS sufferers have found that trazodone improves their quality of life tremendously.

    While it's unusual for trazodone to increase RLS symptoms, some patients have reported this effect. RLS is still not fully understood, and brain chemistry can differ significantly from person to person.

    If you are experiencing an increase in RLS symptoms that coincides with the introduction of trazodone to your drug regimen, let your doctor know. She should be able to recommend a different medication for your insomnia or depression.

    Before considering the possibility that any drug is increasing your symptoms, however, make sure that your body's iron stores are well managed. While you may not be technically anemic, the standard required for RLS sufferers is often different than the scale used for individuals without the disorder.

References

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