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What is the cause of the Restless Leg Syndrome during opiate withdrawal?
RLS is a big problem for me during withdrawal. I have to find something to alleviate my withdrawal RLS. But I don't want to eat a hundred tablets and hope that one will work. If possible I don't want to take muscle relaxants like tetrazepam or any other benzodiazepines. If possible I don't want to take any medicaments which need to be prescribed.
First of all the most important question is surely: Is it really RLS? Is that what tortures us during withdrawal really RLS? Is it the same illness or a completely other thing that we just call the same?
Or maybe it is akathisia? Or PLMS? (I don't know if PLMS is the right abbreviation. The German expression is "periodische Beinbewegungen im Schlaf". Translated that would be: Periodic Leg Movements during Sleep)?
Is it really RLS? Is withdrawal-RLS the same as "normal" RLS? If it is the same, I can be treated the same way. If it is something else with just the same symptoms, I probably has to be treated somehow different.
Can magnesium and calcium help? When I have no deficiency, than probably taking magnesium/calcium will not help?
But maybe I get such a deficiency in withdrawal? A found a study that tells something about changed mineral levels during withdrawal. I do not know how this can be. I have no idea what could be the cause but it seems that some mineral/trace element levels change during withdrawal. (How can that be?)
Furthermore, in withdrawal syndrome, Fe, Mg, Mn, and Ti levels were diminished and Al, Ca, and Cu levels were increased ... Moreover, Mg, Mn, and Se levels were also diminished and Al level was increased
Cemek M, Büyükokuroglu ME, Hazman Ö, Bulut S, Konuk M, Birdane Y. Antioxidant enzyme and element status in heroin addiction or heroin withdrawal in rats: effect of melatonin and vitamin E plus Se. Biol Trace Elem Res. 2011 Jan;139(1):41-54. Epub 2010 Feb 24.
OK. Those are rats in the study. Needn't be the same in humans but seems so be interessting. Let's assume it is the same with humans.
Then could a mineral deficiency cause RLS? I think I read that an iron deficiency could be a cause of RLS. And magnesium deficiency could be a cause, too (or was magnesium only a cause of muscle cramps?)
Then it is maybe possible to defeit RLS with iron or magnesium supplements. But I am not sure if this is really the cause. I'm just trying to find possible causales.
Are there any studies on mineral/vitamine/trace elements levels during withdrawal in humans? I couldn't find anything.
Or maybe withdrawal-RLS has something to do with dopamine levels? Something like temporarily parkinsons disease? Then could L-Dopa treatment help?
Withdrawal and dopamine levels seem to correleate in some way. Dopamine agonists help with parkinson and with opiate withdrawal.
But again I am not sure if maybe a too low dopamine level could be the cause of the RLS.
It seems like medical doctors are not really sure what causes RLS and then maybe they know even less what causes RLS during withdrawal. But maybe somebody knows more than me. Or mabe there are some clinical studies that I could not find.
BTW: I always suffer from RLS during withdrawal and all the addicts I know have the same problem. When I read in internet forums, it seemed for me that RLS is a "usual" withdrawal symptom. But now I found this study:
Scherbaum N, Stüper B, Bonnet U, Gastpar M.: Transient restless legs-like syndrome as a complication of opiate withrawal. Pharmacopsychiatry. 2003 Mar-Apr;36(2):70-2.
This analysis revealed 15 out of 120 patients who had described the symptoms of transient RLS emerging during opiate detoxification treatment.
Only 15 out of 120 patients?? That would be only 12,5%. I really thought, that nearly every addict had this problem. Not? Wrong numbers?
Do you suffer from RLS during withdrawal? Any experiences?
Has anybody found a remedy that really help with RLS during withdrawal?
I thought of trying L-Dopa because it is easy to get in form of mucuna pruriens extract capsules. But those capsules alone would be useless to increase dopamine in the brain. It makes no sense without a decarboxylase inhibitor and no doctor would prescribe this to me. Maybe it is possible to prevent L-Dopa from getting metabolized to early so it can pass whe blood brain barrier with the help of green tea extract?
The website "rlcure [dot] com" claims to have "an absolute cure for RLS". Following the author, RLS is caused by inflammation processes in the body.
I know that there are diseases like rheumatism or arthritis are caused by inflammation processes in the body. But I don't know if this can be THE cause of RLS, too.
I think, some doctor should have realized it. It is possible to detect inflammations in the body by some blood values.
And I think that some RLS patients should have realized it, too. If RLS would have been caused by inflammation then it should probably stop, when a patient takes glucocorticoids like cortisol/hydrocortisone, prednisolone, ... So the inflammation theory sounds a little bit unlogical. But I had only a short look on this website.
When I have a little more time, I will read it more precisely.
I'm so glad you made this thread! Hopefully we will get some good feedback.
Unfortunately I am in the same boat as you. It's 7am my time and I can't fall asleep. Partly from withdrawal and my whole restless body that is caused by withdrawal.
I wonder too if it's not just restless leg syndrome but just restless everything. Including my mind.
I've read (here I think) that hot bath's are really good for the RLS
my bunny lulu took 3 klonopins through-out the night (just took her last one a few minutes ago) and it does help...
Best words of encouragement that I've been telling myself is that it will pass.
Let us know if you come up with any solutions and I'll get back to you with some more info
PS: Super monkey, I feel you. Withdrawals are the worst ever, I'm on day 13 of being clean and still experiencing some less intense symptoms. But extreme heightened anxiety... all day... lol
Last edited by pinky808; 24-03-2012 at 17:12.
Reason: added something
Yeh the whole restless body thing is the most torturous part of withdrawal, that and the insomnia,(and i find it the main culprit for the insomnia)It's not just my legs I get it in my arms and shoulders as well.The aches and pains, shivering, sweating, shitting, I can handle all that but the restless body thing is pure hell.
I have done zero research into what causes it but my gut feeling is it is related to dopamine levels. Some people claim an antipsychotic called seroquel works well at stopping it which seems strange because seroquel like all antipsychotics reduces dopamine levels - but fuck I'm no nueroscientist and even they don't know that much about the brain, so maybe some weird kinda loop makes it work. I knew a girl who used seroquel during detox and reckoned it dealt with both the rls and the insomnia.
I suffer from Restless Leg Syndrome, abbreviated RLS even when coming off using lower doses of opiates "as prescribed" and for short periods of time. For instance, I was on 2mg of hydrocodone up to three times daily, for two weeks. After I stopped them I could NOT stand to be still. Even during the day time I could not sit still in class. I had to keep changing position in my seat and I was squirming around, most likely bothering the people around me too.
I saw that someone mentioned Seroquel working for RLS. I can say that it does work for RLS but not primarily. It has only helped me because it knocks me the hell out in doses of 25mg (which is small compared to what was prescribed to my friend, 300mg), therefore ceasing my awareness of my restless legs because I am out cold for 12 hours at least. But when I wake up, I have to get RIGHT out of bed because the legs are back! It is so menacing!
I do not recommend Seroquel or any other antipsychotics for the alleviation of RLS. They are powerful drugs and have serious side-effects. Some might claim that they aren't dangerous in small doses for short time periods, but they have their own withdrawal which includes aggravating insomnia. A drug that has helped me immensely with RLS symptoms is gabapentin (brand name Neurontin). It is an antiepileptic prescribed frequently for nerve pain and off-label for RLS and fibromyalgia. It is not hard to get this prescribed by a doctor, in my experience.
I did not see this mentioned, but "highlands restful legs" is a decent product for RLS (restless leg syndrome) and can be bought at most drug stores. It is not a "cure" or something that stops RLS completely, but it does help if you take it right after a nice warm/hot bath and soak for about 15 to 20 minutes.
Before going into withdrawals from opiates, just be careful not to overdo it, is to take potassium pills or eat a lot of bananas and other natural foods with potassium. As I said though, you don't want to overdo it.
I did not see this mentioned, but "highlands restful legs" is a decent product for RLS (restless leg syndrome) and can be bought at most drug stores. It is not a "cure" or something that stops RLS completely, but it does help if you take it right after a nice warm/hot bath and soak for about 15 to 20 minutes.
Ive no time for homeopathic products, its nonsense as far as im concerned, but i know that some people swear by them. Although ive yet to come across anyone who does that would take a homeopathic anaesthetic before major surgery
Someone actually gave me that product once, because i had been suffering with some nasty RLS after quitting Kratom. I even took some to keep them happy, but as i knew they were just pills made from water that contained 'the memory' of the ingredients, i couldnt even benefit from any placebo effect.
The problem is that I don't know if this is real RLS. Maybe it is akathisia? Or PLMS? Or something else.
Who said that this withdrawal symptom is really RLS? I could not find real medical texts.
All tese illnesses seem to be caused from different things and should probably not be treated the same way.
I would really be glad if I knew what causes this withdrawal RLS.
Until now I will assume it is (temporary) RLS.
I looked which possibilities there are to treat normal RLS.
Iron deficiency could be a cause. I found a study that said that Fe-levels are reduced in heroin addicts. So I tried to supplement iron. I took it for a month. No effect, I think. I don't know if my withdrawal RLS would be worse if I had not supplemented iron. But in any case: I reduced my methadone dose and I woke up with this ugly RLS which stopped after taking a little more methadone.
Then it is said that valerian root would help a lot of people suffering from (real) RLS.
So I took the strongest valerian root capsules that I could find. I took them nearly 2 weeks and reduced my methadone dose. Again I woke up with RLS. I did not help me.
Consider dietary supplements. Check with a doctor or nutritionist to find out if you’re low on iron, vitamin B, folic acid, or magnesium. Deficiencies can bring on restless legs syndrome (RLS).
- Iron did not work.
- I also supplemented magnesium and calcium (400mg magnesium daily and 800mg calcium). Some magnesium compounds are quickly absorbed by the body (e.g. magnesium citrate) while others take a quite long time. It is said that it should be necessary to take magnesium over longer time in order to fill the body storage. I took magnesium oxide and magnesium citrate for about one month. Maybe it helps to reduce muscle cramps (e.g. leg cramps) but still RLS began when I reduced my methadone dose.
- Vitamin B and folic acid. Folic acid is belongs to the vitamin b complex, too. I took a high dosed vitamin b complex which also contained folic acid. I took it for maybe 3 weeks. No effect for me. Again I woke up suffering from RLS.
Cut back on caffeine. Caffeine often makes the symptoms of restless legs syndrome (RLS) worse. Try reducing or eliminating your consumption of coffee, tea, soft drinks, and caffeine-containing foods such as chocolate.
I stopped drinking coffee last year. I usually drink tea but I stopped it. No tea, no coca cola. Nothing with caffeine. Neither chocolade, altough it contains nearly no caffeine.
It did not work. I cannot tell if RLS would be worse if I had not done this. But actually RLS was worse.
Alcohol and cigarettes shall be able to worsen RLS. I drank no alcohol since the beginning of this year.
But I still smoke...
Some medicaments shall also be able to worsen RLS, especially Diphenhydramine. I did not use this. (Actually I'm afraid of using it for withdrawal. I wanted to try it once in order to help me sleep, but a friend told me that it dreadfully increased his RLS. It seems that a lot of addicts have already made this experience. So I will not try.)
I tried to change my nutrition/diet. I ate as somebody who suffers from rheumatism. For example, I did not eat foods high in arachidonic acid. I did this for more than three weeks.
The same results. I cannot tell if it probably helped to decrease the severity but I stiff suffered from RLS and it was no fun. I would say it did not work.
Maybe all of those things together could help to decrease the severity of RLS. I have not tried it all together. But none of this methods alone was able to stop my RLS or to decrease it to a tolerable level.
But when my RLS starts, usually I also have leg cramps from time to time. I bought "Ben Gay" for that case and some quinine tablets. I realized that I did not need them. OK. When I woke up at night, suffering from RLS, I took another methadone dose in order to stop it.
Maybe this time was too short for leg cramps to occur. But usually this starts quickly for me. It seems that those methods were probably able to prevent leg cramps.
I do not believe in homeopathy. The theory behind this is unlogical. But I don't want to explain this now.
There are a lot of people who say that homeopathy actually helped them. Maybe placebo, maybe not. I will give it a try.
Hyland's sells those preparations: "Restful legs", "Leg Cramps" and "Leg Cramps PM". I searched online and found some postings in drug forums where people wrote, it alleviated or stopped their restless legs syndrome.
I do not think that it will help me, but I will buy "Restfull Legs" and try it.
There are a lot a similarities between RLS and Parkinson's Disease. Maybe the problem is a dopamine deficiency in the brain (or in some parts of the brain) or a neurotransmitter imbalance. This could be possible because low dopamine levels are not only a problem of Parkinson patients but also of drug addicts during withdrawal.
I will try to increase my brain's dopamine levels.
Dopamine is not able to pass the blood-brain-barrier. So Parkinson patients will get L-dopa which is the precursor of dopamine. It is able to pass the BBB and gets then converted to dopamine. That's the theory.
It seems to be possible to supplement Mucuna pruriens which contains a lot a L-dopa. Those mucuna extracts are sold in order to raise dopamine levels. But actually that does not really happen.
L-dopa will get metabolized too early to dopamine in the body. This results in high dopamine levels in the body but not in the brain because when converted to dopamine, it is no more able to pass the BBB.
It has to be prevented that L-dopa gets metabolized already in the body. This shall only happen in the brain when L-dopa has passed the BBB.
In order to reach this, doctors give their patients not only L-dopa but L-dopa plus a decarboxylase inhibitor (like Carbidopa).
This way it is possible that L-dopa reaches the brain (without being metabolized to dopamine) and there it becomes dopamine then.
Unfortunately Carbidopa is a prescription-only medicament and I have no idea what to tell my doctor in order to get it. Every test would show that I have no Parkinson or something else.
So I searched for herbal decarboxylase inhibitors. There is only one herb that maybe could do the job: green tea. But probably it is not enough to drink just some cups of tea. So I ordered the strongest green tea extract, high in EGCG, I could find. (And maybe I will try to take it together with quercetine).
Then I will not use Mucuna pruriens because a found pure (and cheap) L-dopa on ebay.
I found some texts that say that the effects L-dopa supplementation (in healthy persons) can first be felt after 5-7 days. So I will try it for a little more than a week before reducing my methadone dose.
It seems that Parkinson's disease is not only related to dopamine alone. MDMA (which has effect on serotonin) helped Parkinson patient and I think, in Russia those patients are also treated with GABA-drugs. I read advices of using phenibut and picamilon.
Maybe taking phenibut or picamilon could help to alleviate or stop my withdrawal RLS. I also read posting where people wrote that gabapentin, baclofen and pregabalin helped to reduce withdrawal severity.
But all of those medicaments are only to get on prescription (at least in Germany).
GHB/GBL is able to nearly stop opioid withdrawal symptoms completely. It also helps to sleep and stops RLS. It reduced the severity of all my withdrawal to maybe 10%. And made withdrawal quite easy. Escpecially because I was able to sleep.
Although it will not metabolize to GABA, it shall increase the GABA effects. Benzodiazepines also work on GABA receptors but on the wrong type, as it seems. Benzos did not help me during opoiod withdrawal.
Another natural thing which helped a lot of people is "exercise" or "movement".
People suffering from "normal" RLS tell that their symptoms are less severe the more they moved their legs. To go for a longer walk over the day seems to alleviate the symptoms during the night. Exercising shall do the same.
I was not able to try this. I have a really bad leg injury. Some weeks it was inpossible to stand up for me. I am lucky that I can walk on crutshes now but I am still always in pain. It is not possible for me to go for a walk or to exercise with my leg.
How and cold showers seem to help some patients when RLS gets too strong during the night. I cannot try this, too, because of my injury´and my wound dressings/bandages that cover my feet and half the leg.
To promote wound healing, I take some herbal remedies to improve vein-related blood flow. For example I take horse chestnut pills since nearly half a year. Some doctors advice their RLS-patients to try these pills, too.
It seems not to influence my RLS.
There are some other herbal remedies to improve blood circulation that shall help some patients with RLS but I forget the names of the herbs.
Supplemention with 300 I.E. Vitamin E per Tag is said to help. But there is not a single study that proves any effect on RLS. I am not sure if this really helped somebody. But I read this some times.
I had no idea how much 1 I.E. is (I.E. is the German abbreviation for "Internationale Einheit" = international unit. So probably the English abbreviation is I.U..) - so I looked it up. I do not know how this system works. It seems to be a different amount for every vitamin. For vitamin E 1 IU means 910mcg dl-alpha-tocopherol or 670mcg d-alpha-tocopherol.
Vitamin E is often given to oil capsules in order to longer the sell-by-date. I eat Nigella sativa capsules to reduce the pain of my leg injury. The package says every gel capsule contains 500IU of d-alpha-tocopherol. So I took 1500IU per day and this did not help with RLS.
L-Tryptophan is an amino acid that helped some people. While it does not work for some patients, it is a wonder medicine for others. (Sandryk, R., L-Tryptophan in the treatment of RLS. Letter to the publisher. Am J. Psychlat. 143 (4) 534..., 1986
It is a natural, essential amino acid. It is possible to eat foods that are high in tryptophan but I am not sure if this helps because I think tryptophan competes with other amino acids to pass the blood brain barrier. Probably it is the best to take L-tryptophan without (protein rich) food on empty stomach.
Supplemention of 2-3g L-tryptophan in the night time lead to a dramatically improvement of sleep and RLS.
L-tryptophan gets metabolized to 5-HTP and this then to serotonin.
I knew that dopamine deficiency can cause RLS but never heard that serotonin could help.
When this really helps, then probably supplementation with 5-HTP + decarboxylase inhibitor would do the same. Perhaps serotonin reuptake inhibitors can also help. Perhaps could St. John's wort supplementation help, too. I have to get more information on this.
Maybe I will try this before trying to increase my dopamine levels.
These are my reflections and trials until now.
If somebody tried other things or had success with one of the remedies that did not work for me, please write.
I am looking forward to read your thoughts to this topic.
Hi. I suffered from rls when I was little, when I was pregnant and breatfeeding too. Now I am w/d from oramprph, I have it again!! My doc gave me a very low dose of ropinirole and this has helped a lot. You can increase or lower the dose according to your needs. I take a low dose but regularly at the moment. Although I haven't peaked at the worst w/d stage yet. I wonder if it is linked to hormones though given the times I have suffered with it in my life have been times when my hormones have been a mess!
Don't know if this helps. My doc was very reluctant to give me anything that can be swapped effect wise for oramprph but was happy to prescribe me these xxxx
Aside (or in addition) from the mentioned info, I have a few practices which helped me get through this annoying time of recovery:
-ZMA: a mineral supplement that primarily contains Zinc and Magnesium, along with some b-vitamins to help with absorbtion. ZMA is used to increase REM sleep, relax muscles, and is shown to help maintain health testosterone levels (due to supplementing zinc). GNC has a product called "Zinc Magnesium Acetate" (ZMA) that also contains valerian root, which supposedly helps with RLS. If anything, it leads to more intense dreams (good or bad... Lol), and definitely supports rest as well as test levels. (guys- notice your semen volume WILL. IncreSe while taking... Sidenote...)
-Potassium- shown to help hydrate and relax muscles. As an electrolyte, potassium replenishes the salt balance in your body which is responsible for hydrating your muscles. After a long day, especially one with exercise, this is key in relaxing your muscles before bed! You can buy supplement pills, or simply eat a banana!
-EXERCISING MUSCLES TO HELP RELAX-
-try stretching before bed
-exercise! (you should be doing this anyway!... Especially with coming off of opiates- to speed brain chemistry correction)
-Buy a personal vibrating messager. Most drug stores (CVS, rite aid, wall greens...) carry these. A common brand, and one I actually have is made by Wahl. Before bed, or whenever needed, use this all over your body, especially in areas that seem to be the main problem. Vibrating the muscles causes increased blood flow, and also causes muscle fibers to have small contractions as if you were using them. The blood flow and muscle activity will help burn out excess ATP action and therefore leave your muscles tired, and depleted of energy. This simulates similar outcomes that exercising brings. Using this before bed helps your muscles relax, as they (should be) in a state of recovery. Of course, the effects of using a messager alone are nothing compared to coupling it with a good (even minor) exercise regiment.
Of course, drugs mentioned above, such as muscle relaxants or Benzos help with actually getting to sleep, but the above techniques I mentioned will help with the root of your RLS problems. Remember, even adding a little extra exercise, such as walking an extra block, or running up the stairs once or twice really help with many factors of opiate withdrawal. It's the most suggested remedy, as well as the least followed remedy. There is a reason why all successful users recommend this! It's one of the only proven things you can do to help your withdrawal pass faster and more successfully! Contrary to our normal ideas, you can't take a pill for everything! Get up and go! You have all the time in the world (or All night) to veg out in recovery.
looks like youve done alot of research into this and know way more than i do but i honestly beleive prescribed drugs are the only things that will help "RLS" not mineral supplements or homeopathic remedies. i had it in my legs shoulders and chest really bad for nearly 2 weeks, as others have said hot baths and exercise (even just a short walk) helped me alot. if i just stayed in and did nothing all day the nights were worse. i think if there was something that really helped it would be being used by docs to help treat withdrawals.
I see most people seem to have talked about treatments for RLS, and not attempted to answer your actual question.
I guess one good reason for this might be that in all honesty, noone truly knows what actually causes RLS during opiate withdrawal.
As i now understand it RLS itself is thought to be somehow connected to iron and dopamine levels in ones body and my guess would be, in laymans terms, that lack of opiates fucking with your brain chemisty triggers what is basically a nervous disorder.
But there is certainly no solid medical answer that i can find.
Was interesting to read everyones replies to this topic.
I have suffered from RLS before my use of opiates started, and have also seen the re-emergence of RLS after coming off opiates. RLS is in my family, my grandfather and mother both have it, and I started experiencing it when I was about 19 years old. I usually only get it about 2-3 nights in a year, but have had it non-stop for like 5 days now because of withdrawing from opiates. I am in to my 9th day completely clean now and still had minor RLS last night and can even even feel it now (it's the morning).
I think that RLS is caused by something to do with the dopamine receptors. I feel certain that in my case it is something inside the brain that triggers it, not lack of exercise, diet etc... Before I started using opiates I noticed that there are two things that can trigger RLS in me, that may come as a surprise to some. Years ago I was prescribed some antidepressants, (I can't remember which ones) but they were SSRI ones, and for the first few days of taking them my RLS flared up. After a few days it vanished though. Then several months later when I went off the SSRIs I got RLS again for a couple of nights.
The other thing that has caused RLS in me is ecstasy. There have been several times when I have had a pill on a night out, and 4 or so hours after the high is gone and I am in bed and trying to sleep RLS comes for me with a vengeance. It usually only lasts that night (I think from memory, was a while ago). But as I said it was not a one off thing, that happened several times to me after using ecstasy.
But I have to say that withdrawing from opiates is probably the worst case of RLS I have ever had. I actually get it in my arms and shoulders a bit on really bad nights as well. In case you are curious the opiates I was taking was mainly poppy seed tea, poppy pod tea, crude opium, codeine and heroin. I experimented a bit, but 90% of the time I was taking poppy seed tea as I found it cheap, and this may come as a surprise but most of the time it was stronger than heroin. It took till day 3 of abstinence to get RSL, but as I said before it is day 8 clean now, and I am still feeling it. But this is virtually the only symptom I am dealing with still.
Another reason I think RLS is perhaps triggered by dopamine receptors malfunctioning is because I noticed when I started getting clean that a great depression came over me. Because I was using virtually everyday for a year, the depression started to hit me pretty much every morning I woke up. It kept getting worse till about day 5, and then I felt quite a bit better. I would cry at the drop of a hat. I believe this might have been because my dopamine levels were readjusting whilst I was getting sober. I didn't know that opiates effected dopamine levels post-use, which I know is what happens from heavy cocaine use. Can anyone confirm this is what caused my depression?
Thanks for the great post topic.
when i quit methadone i had rls so bad ppl thought i was going to have a seizure.
my problem is it also runs in our family i had it before using opiates to sometimes.
but after my addiction after i quit it was really hellish i had it for months every night.
and its worse now then before also even though im clean thx to the opiates.
when i was in rehab and after i even fell out of my bed a couple times cause of plms and cant count the times i woke up with my blanket on the floor or my sheets totally pulled off.
a guy sleeping on my room could not sleep at night cause i was moving around so much in my sleep.
the said i was breakdancing in my sleep.
they gave me seroquil to sleep in low doses it helps u to sleep in higher doses its a anti psychotic.
and quinine which totally did not help me.
actually i still get it almost every day but far less serious.
but i cant lie down and rest in my clothes il get it for sure i have to sleep full commando, if im sitting down and im bored il get it, on the plane i will get it, in the car i will get it etc.
i dont drink coffee or tea or anything with caffeine in it.
when i drink alcohol im guaranteed at a night of nasty restless legs lol.
In my case only time heals the wounds slowly. benzos did not help clonidine did not help etc.
only weed seems to take the edge of a bit.
and i also lived in the bathroom for extended periods of time.
i heard from a guy baclofen worked good but i never received that med.
Not sure if anyone mentioned this but rls is caused by lack of dopamine during withdrawals. If your not in withdrawals irondeficiency certainly can cause rls. Low magnesium can also contribute but during opi withdrawals only increasing dopamine really works for severe rls. I suffered rls for years so badly i would wake up with severe muscle craps from clutching so hard at night it was hell. Now during withdrawals i am debating taking a hammer to each limb lol. Nothing hasreally helped during opi withdrawal in my case.
gman2858 added 1 Minutes and 27 Seconds later...
Btw Mmj and xanax only made it worse for me. Not sure why, it only made me super tired and want to crawl out of my skin
I don't know what causes RLS either but I suffer from it so bad when I am in WD!s(: About 12 hours after any dose of Opiates, including my Suboxone and Subutex withdrawals start in on me. Starts in my legs, goes to arms then finally body. I've had it so bad I've stood in the side of my bed crying my eyes out begging God to stop it, hoping the standing makes my legs stop kicking. That's where the term "kickin dope" comes from, we are literally kicking our legs.
The only thing that works somewhat for me is Xanax. I take 1 and a half and it knocks me out for a little. By then I have to have the drugs or it gets waaaaayyy worse. I have Soma, a muscle relaxer BUT, in my experience it has made RLS worse. Not sure why but that was a huge mistake one night. Thank God I could fill my script the next morning.
I was given Baclofen and Clonodine once for withdrawals and they didn't do jack shit squat either! Ugh...I think I just have a heavy issues with RLS and WD's. Never had RLS before I started taking Opiates.
Hope things get better for you and anyone reading this thread. It's so tough going through that! I fear RLS more than things that could be worse...horrible feeling.
Full text can be found at- The National Institute of Neurological Disorders and Stroke.
What causes restless legs syndrome?In most cases, the cause of RLS is unknown. However, it may have a genetic component; RLS is often found in families where the onset of symptoms is before age 40. Specific gene variants have been associated with RLS. Evidence indicates that low levels of iron in the brain also may be responsible for RLS. Considerable evidence suggests that RLS is related to a dysfunction in the brain’s basal ganglia circuits that use the neurotransmitterdopamine, which is needed to produce smooth, purposeful muscle activity and movement. Disruption of these pathways frequently results in involuntary movements. Individuals with Parkinson’s disease, another disorder of the basal ganglia’s dopamine pathways, often have RLS as well.
RLS also appears to be related to the following factors or conditions, although researchers do not yet know if these factors actually cause RLS:
Chronic diseases such as kidney failure, diabetes, and peripheral neuropathy. Treating the underlying condition often provides relief from RLS symptoms.
Certain medications that may aggravate symptoms. These medications include antinausea drugs (prochlorperazine or metoclopramide), antipsychotic drugs (haloperidol or phenothiazine derivatives), antidepressants that increase serotonin, and some cold and allergy medications-that contain sedating antihistamines.
Pregnancy, especially in the last trimester. In most cases, symptoms usually disappear within 4 weeks after delivery.
Alcohol and sleep deprivation also may aggravate or trigger symptoms in some individuals. Reducing or completely eliminating these factors may relieve symptoms, but it is unclear if this can prevent RLS symptoms from occurring at all.
How is restless legs syndrome diagnosed?
There is no specific test for RLS. The four basic criteria for diagnosing the disorder are:
Symptoms that are worse at night and are absent or negligible in the morning;
A strong and often overwhelming need or urge to move the affected limb(s), often associated with paresthesias or dysesthesias;
Sensory symptoms that are triggered by rest, relaxation, or sleep; and
Sensory symptoms that are relieved with movement and the relief persists as long as the movement continues.
Physicians should focus largely on the individual’s descriptions of symptoms, their triggers and relieving factors, as well as the presence or absence of symptoms throughout the day. A neurological and physical exam, plus information from the individual’s medical and family history and list of current medications, may be helpful. Individuals may be asked about frequency, duration, and intensity of symptoms as well as their tendency toward daytime sleep patterns and sleepiness, disturbance of sleep, or daytime function.
Laboratory tests may be performed to rule out other conditions. Blood tests can identify iron and vitamin deficiencies as well as other medical disorders associated with RLS. In some cases, sleep studies such as polysomnography (a test that records the individual’s brain waves, heartbeat, breathing, and leg movements during an entire night) may identify the presence of other causes of sleep disruption (e.g., sleep apnea), which may impact management of the disorder.
Diagnosing RLS in children may be especially difficult, since it may be hard for a child to describe where it hurts, when and how often the symptoms occur, and how long symptoms last. Pediatric RLS can sometimes be misdiagnosed as "growing pains" or attention deficit disorder.
How is Restless Leg Syndrome Treated?
RLS can be treated, with care directed toward relieving symptoms. Moving the affected limb(s) may provide temporary relief. Sometimes RLS symptoms can be controlled by finding and treating an associated medical condition, such as peripheral neuropathy or diabetes. Certain lifestyle changes and activities that may reduce symptoms in persons with mild to moderate symptoms include decreased use of caffeine, alcohol, and tobacco; supplements to correct deficiencies in iron, folate, and magnesium; changing or maintaining a regular sleep pattern; a program of moderate exercise; and massaging the legs, taking a hot bath, or using a heating pad or ice pack. A trial of iron supplements is recommended only for individuals with low iron levels. Although many people find some relief with such measures, rarely do these efforts completely eliminate symptoms.
Medications are usually helpful but no single medication effectively manages RLS for all individuals. Trials of different drugs may be necessary. In addition, medications taken regularly may lose their effect over time, making it necessary to change medications periodically.
Common drugs prescribed to treat RLS include: Dopaminergic agents (drugs that increase dopamine), largely used to treat Parkinson's disease, have been shown to reduce symptoms of RLS and PLMS when they are taken at bedtime and are considered the initial treatment of choice. The U.S. Food and Drug Administration has approved ropinirole, pramipexole, and rotigotine to treat moderate to severe RLS. Both drugs are generally well tolerated but can cause nausea, dizziness, or other side effects. Good short-term results of treatment with levodopa plus carbidopa have been reported.
Although dopamine-related medications are effective in managing RLS, long-term use can lead to worsening of the symptoms in many individuals. This apparent progressive worsening is referred to as “augmentation.” With chronic use, a person may begin to experience symptoms earlier in the evening than in the afternoon until finally the symptoms are present around the clock. The initial evening or bedtime dose becomes less effective, the symptoms at night become more intense, and symptoms begin to affect the arms or trunk. Fortunately, this apparent progression is reversible by removing the person from all dopamine-related medications. Another important adverse effect of dopamine medications that occurs in some people is the development of impulsive or obsessive behaviors such as obsessive gambling or shopping. Should they occur, these behaviors can be reversed by stopping the medication.
Other medications may be prescribed “off-label” (not specifically designed to treat RLS) to relieve some of the symptoms of the disorder. Benzodiazepines can help individuals who have mild or intermittent symptoms obtain a more restful sleep. However, even if taken only at bedtime they can sometimes cause daytime sleepiness. Benzodiazepines such as clonazepam and diazepam are generally prescribed to treat anxiety, muscle spasms, and insomnia. Because these drugs also may induce or aggravate sleep apnea in some cases, they should not be used in people with this condition. Opioids such as codeine, propoxyphene, or oxycodone may be prescribed at night to diminish pain and help to relax individuals with more severe symptoms. Side effects include dizziness, nausea, exacerbation of sleep apnea, and the risk of addiction. Anticonvulsants such as gabapentin and pregabalin can decrease the sensory disturbances such as creeping and crawling sensations and nerve pain. Dizziness, fatigue, and sleepiness are among the possible side effects What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS), a component of the National Institutes of Health, is the primary Federal sponsor of research on brain and nervous system disorders. The NINDS seeks to increase scientific understanding of RLS, find improved methods of diagnosing and treating the syndrome, and discover ways to prevent it.
NINDS-supported researchers are investigating the possible role of dopamine function in RLS. Researchers suspect that impaired transmission of dopamine signals may play a role in the disorder. Additional research should provide new information about how RLS occurs and may help investigators identify more successful treatment options.
Workshops and conferences sponsored by the NINDS as well as nongovernment organizations have emphasized the need for further research on animal models and the complex roles of dopamine interaction with iron levels. For example, serum ferritin, an index of iron deficiency, has been shown to predict the severity of RLS symptoms in older individuals.
Published on May 12, 2013 by Dr,Mark Borigini M.D. in Overcoming Pain
Neurologists have long wondered why so-called “dopaminergic” (dopamine being a brain neurotransmitter) treatments help restless leg syndrome (RLS), but not the slepp loss associated with that disorder; even as, at least from the patient’s perspective, this lack of sleep may just be no big deal: While research has shown that RLS patients sleep on average a little over five hours each night, the typical RLS patients does not report excessive sleepiness during the day. It may be that this apparent arousal component of RLS is due to the effects of “glutamatergic” (glutamate and glutamine being two other brain neurotransmitters) activity.
This month’s issue of the journal “Neurology” discusses the results of an investigation into brain glutamatergic activity. The researchers studied the ratio of total glutamate and glutamine concentration to the total creatine, their hypotheses being that the ratio would be higher for RLS patients, and the ratio would directly correlate with insomnia during the sleep period.
The use of MR spectroscopy examined the brains of the RLS patients, comparing this image to a control group. Some patients underwent a sleep study also, and researchers found a positive correlation between brain glutamatergic activity and arousal, and/or the amount of time awake during what should have been a sleep period. In fact, glutamatergic activity also correlated with things such as waking after the patient finally began to sleep, and just how long it takes for that patient to fall asleep.
Interestingly, glutamatergic activity showed no association with the leg movements of RLS, although, the higher glutamate levels did result in a more sleep-disturbed RLS patient.
And the control group with no sleep problems had stable glutamate levels, and proved to be resistant to the other findings that can be observed in the course of a sleep study.
There are glutamate-reducing drugs already on the market (including Neurontin, and Lyrica), and in the future it would be interesting to see whether these drugs play a role in improving sleep. In the clinic, perhaps a cocktail of glutamate reduction to help sleep, in combination with dopamine agents to help the leg movements of RLS would be helpful.
As always, one must consider the hypothesis also, and not just what is being studied that might validate or reject the hypothesis: Perhaps this glutamatergic activity is not causing the sleep problems of RLS patients. Perhaps the sleep difficulties of RLS simply trigger the brain to produce more glutamate. Making things more confusing is that not every RLS patient has elevated glutamate levels.
There is a significant amount of chronic pain associated with RLS and the sleeplessness that accompanies this disorder. Many patients await the studies that are sure to follow.
Last edited by Thirst4knowledge; 24-06-2013 at 03:58.
Reason: Additional material
A friend of mine told me her son was an addict, and he took prenatal vitamins when he was going through withdrawals. She said it helped him a lot due to the high levels of vitamins in the pills that he was depleted in.
Here's a wild idea to toss out there:
I did a six week taper off 40mg of hydrocodone. I did three weeks without Clonidine, and three weeks with Clonidine. According to Mayo Clinic's website, it works in the brain to change some of the nerve impulses. It is used alone or together with other medicines to treat attention deficit hyperactivity disorder (ADHD). It works by increasing attention and decreasing restlessness in children and adults who are overactive, cannot concentrate for very long, or are easily distracted and impulsive. This medicine is used as part of a total treatment program that also includes social, educational, and psychological treatment.
Anyway, the first part of my taper was pure hell. I wanted to jump out of my skin. It was horrible. I could not sit still, yet I was in agony with some injury pain and hyperalgesia. I could not sleep worth a crap. I would wake in a sweat, I had such nervousness and diarrhea. It was terrible. After beginning Clonidine, I was calm, relaxed, no more needing to move, I slept. It was like a miracle. Most of the withdrawal hell stopped for me, other than the aches. Maybe it is the nervous system that causes the restless leg thing? I know that opiates do decrease dopamine in the brain and while we are on the stuff, we are happy and content---relaxed. When we go off, our brain has to begin making dopamine again and it takes time to catch up from the loss of being on narcotics. I did some research and SAM-e is supposed to help with dopamine, so I began taking it. It may have boosted my mood, or it is just the 80 days under my belt of being off the opiates? I also read 5htp can help, too. But some stuff cannot be used if a person takes antidepressants.
Just thought I would toss out the Clonidine fix. For some reason, it worked for me--well. The restless leg and body issue stopped almost immediately when I took the drug. I am still on it and am afraid to come off it! I don't want anxiety from being off the drugs! Not sure when that all ends!
This last come down off of opiates I wanted to be prepared for the RLS hell. So I went to the doctor and got a script of Sifrol (Pramipexole) used to treat parkinson's and RLS. I started taking it on day 1 of withdrawal and kept taking it for a week. It didn't help at all. Apparently I was on a low dose, and the correct way to take it is to take it everyday to build up enough in your body or brain or something. I don't agree with taking a drug everyday to treat a problem that I only get 1-2 nights a year; I got RLS before opiate abuse. Every time I withdraw I am guaranteed to get RLS. But it isn't just in my legs, in fact this last time it was worse in my arms and chest. Maybe I should ask for Clonidine next time if you reckon it works immediately after taking the first dose? I notice it is a medication used for RLS.
Originally Posted by
But I have to say that withdrawing from [AUTOLINK
opiates[/AUTOLINK] is probably the worst case of RLS I have ever had. I actually get it in my arms and shoulders a bit on really bad nights as well. In case you are curious the opiates I was taking was mainly poppy seed tea, poppy pod tea, crude opium, codeine and heroin. I experimented a bit, but 90% of the time I was taking poppy seed tea as I found it cheap, and this may come as a surprise but most of the time it was stronger than heroin. It took till day 3 of abstinence to get RSL, but as I said before it is day 8 clean now, and I am still feeling it. But this is virtually the only symptom I am dealing with still.
Right on! I was abusing PST for around 2 years mixed with a few oxys here and there plus CWE codiene pills and by far the PST was the strongest and longest lasting. I read somewhere that a strong dose of PST is like intranasal heroin.(never done H myself) But PST had my nodding out at the most inconvenient times.
I have been clean now for 5 days. Day 1 was hell on earth, day 2 a little better, both days no RLS just shits, sweats and depression. I thought, sweet at least i dont have the RLS like my last withdrawal. Then as you say... Bang! Day 3 The motherflippin RLS hit like a tonne of bricks! I was flailing around on the bed like i had been electrocuted. I hopped up 3 times that night to have a hot shower and settle them. Munched 2mg clonazapam.......nothing, absolutely nothing. Even had some Levodopa/carbidopa pills and they did jack shit. I just felt like a half conscious bag of meat being flipped around in a frying pan. It was about 30 degrees C that night. Day 4 same shit different day, eating bananas like no-ones business, herbal crampeze pills and hot showers. Watched an episode of Game of Thrones today where they were sawing someones leg off and i though, lucky bastard!
Good on you for getting clean. I hope these mongrel legs settle soon.
Poppy seed tea= cheap and effing nasty. Dont do it. Unless you like RLS......