Restless legs syndrome causes an urge to move the affected part of the body to temporarily decrease uncomfortable sensations. It affects the legs most commonly; it can also affect the arms or other parts of the body. Sensations may include burning, tingling, creeping or tugging, and an exact cause is not known. The mechanism leading to the syndrome has been linked to decreased dopamine in the brain and decreased iron utilization by the body. One trigger for those with the syndrome is the use of certain medications.
Antipsychotic Drugs
Since restless legs syndrome is associated with decreased dopamine in the brain, medications that deplete dopamine can make symptoms worse according to a 2008 article in "Neuropsychobiology." Psychotic disorders are often associated with the opposite problem: increased levels of dopamine in the brain. Some antipsychotic medications such as haloperidol or chlorpromazine decrease dopamine levels and therefore may worsen restless legs syndrome.
Antinausea Drugs
Nausea is stimulated from the gut or the effects of compounds in the blood on the brain. Antinausea drugs may exert their effects on the GI tract, the brain or both. Metoclopramide is a nausea medication that works in the GI tract to increase the passage of food along the tract and decreases the signaling of dopamine in the brain. Prochlorperazine is another nausea medication that decreases dopamine levels in the brain.
Antidepressants
Antidepressants such as selective serotonin reuptake inhibitors and tricyclics have been shown to aggravate restless legs syndrome according to a January 2001 article in "Current Medical Research & Opinion." Examples of drugs in the former class include fluoxetine, brand name Prozac, sertraline and citalopram. Tricyclics are not used as frequently. Examples of drugs in this class include amitriptyline and nortriptyline. Lithium, used to treat bipolar disorder, is also noted to increase the symptoms of restless legs.
Antiseizure Drugs
Antiseizure medications such as gabapentin and carbamazepine are used to treat restless legs syndrome, although they are not a first line treatment. Not all seizure medications are useful for treatment, however, according to the National Institute of Neurological Disorders and Stroke. Some actually make the condition worse. Two such examples are the drugs phenytoin and droperidol.
Recreational and Over-the-Counter Drugs
Caffeine, nicotine and alcohol have all been implicated in making restless legs syndrome worse, according to the National Institute of Neurological Disorders and Stroke. Their avoidance is recommended as part of the lifestyle changes used to treat the condition. In addition, certain over-the-counter drugs make restless legs worse, particularly cold and allergy medications such as diphenhydramine.
References
- National Institute of Neurological Disorders and Stroke:Restless Legs Syndrome Fact Sheet
- "Neuropsychobiology"; Association Study between Antipsychotics- Induced Restless Legs Syndrome and Polymorphisms of Dopamine D1, D2, D3, and D4 Receptor Genes in Schizophrenia. Seung-Gul Kang et al; 2008
- "Current Medical Research & Opinion"; Antiemetics; E. A. MacGregor; January 2001
- American Family Physician: Restless Legs Syndrome: Detection and Management in Primary Care;
- Family Practice Notebook: Restless Legs Syndrome
