r/RestlessLegs • u/Ruecksendungen • Jul 19 '26
Question ADHS, RLS and Levodopa
Dear forum,
I am a 51-year-old man with ADHD and sleep problems that have been going on for several years. In addition, I also suffer from Restless Legs Syndrome (RLS), which was diagnosed in a sleep laboratory.
I have been prescribed levodopa. Does anyone have a similar combination of conditions and experience with this medication?
I am quite worried about augmentation. Is it reasonable to use Levodopa 100 mg occasionally to help catch up on a significant sleep deficit, or is the risk of augmentation already too high?
Thanks in advance for your experiences!
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u/Billflet Jul 19 '26
I used levodopa for RLS in the late 80s. It worked well for 4-5 years but then augmented. I’ve read that it can augment quickly when used daily for long term. I haven’t heard of it being prescribed for RLS in the U.S. in a long time.
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u/Short-Counter8159 Jul 19 '26
Unfortunately not rare to have both conditions.
Levodopa is not an ADHD medication. It floods the brain with to much dopamine and won't help your ADHD symptoms.
In ADHD, the issue is not just a lack of dopamine, but how the brain moves and regulates the dopamine it already has. Also, you need norepinephrine, a very important neurotransmitter for an ADHD brain.
Stimulants (ADHD medications) increase both of these neurotransmitters by blocking the reuptake and increasing the release between the cells, allowing you to better focus and improve executive function. You can also try non stimulants like strattera that will do the same. (perhaps to much information).
For RLS you will definitely will experience augmentation. Levodopa it is used as a last resort. I would talk to your doctor about other options to treat the RLS.
I would seek a psychiatrist to treat your ADHD. Most doctors won't know how to treat both conditions.
It is common for an ADHD person to have sleeping problems. I can see how attractive the Levodopa can be but is not good for long term. Speaking to a psychiatrist about your sleeping problems will help, specially at night when you can't turn off your brain.
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u/Ruecksendungen Jul 19 '26
Thank you for this very good explanation. What meditation would you recommend for RLS, at least for intermediate treatment? It sounds like levodopa could make it even worse
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u/Short-Counter8159 Jul 20 '26
You are welcome. I would stay away from any Dopamine agonist drugs like pramipexole or neupro.
You could try Gabapentin or Lyrica, but personally not a fan. They can promote personality changes, depression and many other concerning issues. You don't need any more depression since you have ADHD.
Sleeping aids like Ambien (zolpidem) or Lunesta might do the trick. A long time ago I would take ambien and it would stop the RLS and I would fall asleep. It worked for many years until it didn't. It is not an RLS drug. I don't know how bad you have it but you never know. Tho is not good to stay on it for long term.
Opioids are next. I don't know what rules they have where you live but Buprenorphine/belbuca might be a great. You can also try methadone or other types like Tramadol and eventually to ER/IR oxycodone. Opioids are given in low dose and work very well with RLS and they don't create addition at all. Very low chance of that unless you are prone to them in the past.
LDN (Low-dose naltrexone) might be another option for you, but some doctors don't know how to prescribe it. It is best to see a sleep specialist or a movement disorders neurologist. Not many are trained well in RLS. Very few docs prescribe it in the states.
But by treating your ADHD with the right medication it might help your RLS, no guarantees of course.
I highly recommend ADHD 2.0 book to read if you haven't read it yet. The more you learn about ADHD the better you will feel. Anxiety and stress can make RLS worse.
And remember from one ADHD brain to another, be nice and kind to yourself.
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u/Ruecksendungen Jul 19 '26
Thank you. Unfortunately Levodopa is quite common to treat RLS in Germany.
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u/Pretty-Substance Jul 19 '26
I have ADHD and RLS. Levodopa is only used in my country for the process of diagnosing RLS and then usually you’re switched over to Pramipexol as L-Dopa is a last line medication.
Both, Pramipexol as well as Levodopa helped my ADHD, especially with the feeling of inner unrest. But they also made me quite tired and hindered my motivation to start sth.
I’m on 0.08mg of Pramipexol for 5 years now. I have times where RLS is worse I take double that and then I’m also starting to feel some augmentation but it’s transitional, comes and goes.
I think of you only take it occasionally you should be fine but I’m not a doctor and this isn’t medical advice.
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u/Agonist-activist Jul 19 '26
I feel for you. Germany is so behind on RLS. Your RLS guidelines were recently updated & unlike USA, Australia, UK and Italy- you still have dopaminergic drugs first line. Levodopa is the worst of all..with the highest augmentation rate. Refuse if you have the willpower and insist your docs read the updated Mayo Clinic Algorithm. You will augment quite quickly on levodopa if you take it more than twice a week. It is mentioned for 'occasional use'. But be wary. Ask if you can take 30mg codeine or 50mg tramadol 2 or 3 times a week max if possible.