Medications to Avoid
Avoiding trigger medications
A number of medications can make RLS worse and identifying these and changing to safer alternatives may improve your RLS and reduce the need to take additional medications. Any changes to medication should always be discussed with your doctor
In particular, anti-nausea drugs and sedating antihistamines can block the brain’s dopamine receptors, increasing the symptoms of restless legs. Antidepressants that increase serotonin and antipsychotic medications can also aggravate the condition. Let your doctor know if your restless legs symptoms worsen after you take a new medication. A change in dosage or a change to a different medication may help. Below we have listed a number of medications which our forum users suggested made their RLS worse. Please note that this list is not exhaustive and while we have been advised that they have made RLS symptoms worse for some people, this may not be the case for you.
Cold and Flu remedies and Anti-Histamines: Common culprits include: Night Nurse, Day Nurse, Nytol, Actifed, Avamys, Benadryl (Acrivastine), Chlorphenamine ( Piriton), Contac, Coricidin, Fluticasone, Rhinolast (Azelastine hydrochloride), Sinutab, Sudafed. Note that many cough syrups may contain antihistamines, especially if they are recommended for cold or flu symptoms. Anything containing pseudoephrine or phenylephrine should be avoided. Always try to choose non-drowsy options.
Anti-depressants: Many people living with RLS also live with depression and consequently are prescribed anti-depression medication. RLS is also common in two conditions that often co-occur with depression: ADHD and PTSD. However some anti-depressants can actually make RLS symptoms worse. If you are prescribed anti-depressants and live with RLS, we recommend you monitor your RLS symptoms to see if your symptoms worsen after starting anti-depressant medication. If so, speak to your medical practitioner to see if you can be prescribed an alternative medication. Trazodone and Bupropion are both RLS safe alternatives.
Anti-psychotics: Most anti psychotics worsen RLS.
Selective Serotonin-Reuptake Inhibitors (SSRIs) and Serotonin and Norepineephrine Reuptake Inhibitors (SNRIs):
Citalopram (Cipramil), Duloxetine (Cymbalta), Venlafexine (Efexor), Escitalopram (Cipralex), Paroxetine (Paxil, Seroxat), Fluoxetine (Prozac), Nefazodone (Serzone, Dutonin, Nefadar), Sertraline ( Zoloft, Lustral), Dapoxetine (Priligy), Fluvoxamine (Faverin), Vortioxetine (Brintellix).
Tricyclic medications: Amitriptyline (Tryptizol), Clomipramine (Anafranil, Imipramine (Tofranil), Lofepramine (Gamanil), Nortryptiline (Allegron), Amoxapine, Desipramine (Norpramin), Doxepin, Trimipramine, Imipramine, Mirtazapine ( Zispin), Protriptyline, as well as others, have been suggested as making the symptoms of RLS worse.
Antacids: Most Proton Pump Inhibitors worsen RLS. Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole, Esomeprazole.
Anti Nauseates: Discuss any anti nauseates with your doctors before surgery as many, including prochlorperazine or metoclopramide) will trigger RLS during and after surgery. Safe alternatives include Odansetron ( Zofran), domperidone or granisetron hydrochloride.
Statins: Many people report that statins worsen their RLS symptoms e.g. Atorvastatin or Rosuvastatin. Alternatives are available although some may be less effective and should always be discussed with your doctor. Ezetimibe (Zetia) works differently from statins in that it inhibits the intestinal absorption of cholesterol and is recommended in the UK if a statin is “inappropriate or not tolerated”. It generally works more slowly than a statin, so may not be suitable for those with very high LDL.
Other alternatives include Fenofibrate (Triglide in the US, Fibricor, Lipantil, Lipofen, Supralip) and Bezafibrate (Bezalip) which are not statins.
Bempedoic acid works by reducing the production of cholesterol in the liver and Nustendi (Nexlizet in the US) combines ezetimibe with bempedoic acid for a cholesterol lowering drug that is again not a statin.
A potentially more difficult way to reduce cholesterol is to go vegan or make significant changes to your diet, some of which may also have a direct bearing on your RLS symptoms as described in Non-Medical Treatments