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CaliforniaMD
CaliforniaMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 1495
Experience:  board certified neurologist
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My legs twitch, jerk and kick at night or even during the day

Customer Question

My legs twitch, jerk and kick at night or even during the day while attempting to take a nap. My Dr. prescribed requip, 25mg but it only seems to mildly calm my legs down. It does make me drowsy to go to sleep but I wake up within 2 hours with leg movements. I do have very low iron and am taking 1 ferrous gluconate tablet a day. I even eat cream of wheat daily. I also had an endometrial ablation performed a month ago due to heavy bleeding. The issues with my legs are still going on. This is making me irritable and frustrated. Is there anything else I can do or my Dr. can do for me?
Submitted: 2 years ago.
Category: Neurology
Expert:  CaliforniaMD replied 2 years ago.

it sounds like you have PLMS, periodic leg movements of sleep and probably restless leg syndrome.

other than vicodin and requip have you tried any other drugs?

are your iron and ferritin level getting better?

Customer: replied 2 years ago.
I did try Siminet (?) and it did not help at all. I was waking up taking 3 tablets within my hours of sleep so the Dr. put me back on vicodin. It works great, but I was concerned about getting addicted to it and couldn't get a refill so I went back to the Dr. and was prescribed requip. She prescribed 25mg, but I take 50mg each night and I still wake up from the movements. Last night was really bad so i added a 1/2 of a vicodin and finally fell asleep after 4:30 am. I don't really know if the iron and ferritin are getting any better, but since my surgery on Sept. 27th I don't think it has.
Expert:  CaliforniaMD replied 2 years ago.

hi again,

very important to bring the ferritin up over 50. low ferritin can trigger or make RLS and PLMS worse.

if requip or sinemet don't work and you don't want to use opiates on regular basis, there are a few more options:

- you are on a low dose of requip (0.25mg - 0.5mg -- it doesn't come in 25 or 50); you can work the dose up to 3-4mg, 1-2 hours before bedtime, or slightly higher dose if necessary, with your doctor

- try requip XL; extended release doesn't wear off as fast and might help you get through the night

- try muscle relaxant like baclofen or robaxin

- try gabapentin which in some patients works very well; start at 300mg at night and go up to 600mg or higher if needed over a few weeks



Customer: replied 2 years ago.
One other thing I forgot to mention. My blood pressure has been borderline high (144/88, 136/80 -- this is what I wrote down the last 2 times) the last 4-5 times I have gone to the dr. Should I try to relieve the RLS first or do you reccommend that I take blood pressure medication. I have been exercising for a month and eating heathy, but my blood pressure has not improved in that time.
Expert:  CaliforniaMD replied 2 years ago.

i'd cut back on salt a lot -- this can make a big difference.

sleep deprivation can raise blood pressure (and cortisol level).

if your BP hasn't improved in 30 days of healthy lifestyle, you may need a little diuretic to help you get rid of extra fluid.

you should take care of both and you PCP can do it for you.

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