Suggest Treatment For RLS

Posted on Tue, 24 May 2016

Question: I HAVE BEEN TAKING REQUIP XL FOR RLS FOR 6 OR 7 YEARS. I HAVE BIPOLAR TYPE 2. I had tried Mirapek first but it didn't help. I just spent 5+ months under the care of a XXXXXXX Clinic dr. in Las Vegas. (underwent endless tests and physic and occupational therapy). I'm taking a 3 month break from therapy until XXXXXXX Dr. feels Requip isn't good for RLS and that I should just increase my backup drug, Klonipin. It doesn't get rid of the intense anxiety if I forget to take Requip earlier. I take 2 mg twice a day of Requip. Dr. couldn't find a psychiatrist that deals with Bipolar Type 2 here. There just doesn't seem to be meds for RLS. Any thoughts?

Answered by Dr. Chintan Solanki (6 hours later)

Brief Answer:
if bipolar symptoms are there, mood stabilizer can be added

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.

Requip, Klonopin and neurontin all are used in treatment of RLS. Requip is almost first line of therapy, klonopin is second and neurontin is third. Depending on severity combination of drugs can be used.

If I were your treating doctor I would recommend continuing/increasing requip rather than klonopin. Klonopin is benzodiazepine with anxiety relief it may cause sedation and considering your age I wouldn't recommend increasing the dose of klonopin.

In bipolar 2 there can be hypomania or depression. For depression you are already on lexapro. When hypomanic symptoms are there, mood stabilizer like lamotrigine or seroquel can be used.

Hope this answer will help, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

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Above answer was peer-reviewed by : Dr. Prasad