Does tizanidine cause restless leg syndrome? (+3 drugs)

In this article, we will discuss whether tizanidine causes restless leg syndrome. We will also share some evidence from research regarding this topic, and mention some other causes of restless leg syndrome and its treatments.

Does tizanidine cause restless leg syndrome?

No, tizanidine does not commonly cause restless leg syndrome (RLS) and it is not a reported side effect of tizanidine. In fact, research shows that tizanidine may help improve the quality of life of patients with RLS by promoting sleep.

Tizanidine is a muscle relaxant used to manage spasticity that may occur as a result of injury to the brain and spinal cord, multiple sclerosis, and stroke. It can also be used for chronic headaches and chronic pain of the neck and lower back (1).

Tizanidine is a centrally acting alpha-2 agonist that suppresses the release of stimulatory amino acids like glutamate and aspartate and reduces the stimulation of spinal motor neurons (1).

RLS is a neurological, chronic, movement disorder characterized by an irresistible urge to move the legs to relieve uncomfortable and abnormal sensations. These sensations are produced in the legs and may include crawling, itching, or pulling (2).

RLS can be caused as a side effect of many medications however it is not reported by patients taking tizanidine. Additionally, research indicates that tizanidine may be beneficial for some patients with RLS.

However, individual response to medication varies and RLS may occur while taking tizanidine as this drug acts on the central nervous system (CNS). Contact your healthcare provider if you experience RLS while taking tizanidine.

What does research suggest?

The reports of RLS occurring with tizanidine are scarce and this side effect is not associated with muscle relaxants. However, taking muscle relaxants may be beneficial to improving sleep which is impaired in RLS.

Research shows that patients with RLS frequently experience sleep disruption as the symptoms of RLS are worsened at night. Sleep disruption decreases the quality of life and addressing this issue can cause significant improvements.

In one study, the arousal patterns of sleep were investigated in patients with RLS following the fact that despite improvement in RLS symptoms after treatment, some patients still experience arousal during sleep (3).

The findings of this study showed that patients with RLS had increased glutamatergic activity contributing to arousals. The study suggested a potential of targeting this imbalance in improving RLS (3)

Due to the inhibitory effect of tizanidine on glutamate, it can be beneficial in helping RLS based on these findings. If not, tizanidine can still be helpful as it promotes sleep and can reduce arousal due to RLS symptoms.

Fibromyalgia is listed as a secondary cause of RLS (2) and research shows that RLS is commonly found among patients with fibromyalgia (4). Tizanidine has been found effective in managing the symptoms of fibromyalgia (5).

Thus, through the mechanism of action, tizanidine can improve RLS symptoms, improve sleep, and help manage other conditions related to RLS.

What are some other causes of restless leg syndrome?

RLS can be inherited, caused by other health conditions like fibromyalgia and celiac disease, or may occur secondary to medications like trazodone and Celexa. The following are the causes of restless leg syndrome (2):

What to do if tizanidine causes restless leg syndrome?

Tizanidine does not commonly cause RLS and is less likely to result in this side effect. If you experience RLS while taking this medication, contact your healthcare provider. Your healthcare provider will assess you to find the underlying cause.

If RLS is being caused by tizanidine, your healthcare provider will suggest you discontinue this medication and will prescribe an alternative drug. This however is unlikely as tizanidine does not cause RLS.

Your healthcare provider will address factors like stress, fatigue, and iron deficiency if present, to resolve the issue of RLS. Nonpharmacological management of RLS involves engaging in physical or mental activities to eliminate RLS symptoms (6).

Your healthcare provider may consider pharmacological treatment if RLS is frequent and causing severe discomfort. Different medications can be used to manage RLS based on the symptoms like (6):

• benzodiazepines like zolpdiem
• low-potency opioids like codeine
• dopamine agonists like ropinirole
• anticonvulsants like gabapentin

What are some other side effects of tizanidine?

RLS is not a common and reported side effect of tizanidine. Commonly reported side effects of tizanidine include the following (1):

• drowsiness
• constipation
• blurry vision
• nervousness
• asthenia
• hallucination
• rhinitis
• dizziness
• xerostomia

If you experience any adverse effects while taking tizanidine, contact your healthcare provider.

In my experience:

As per my understanding, tizanidine does not cause restless leg syndrome. RLS is not reported with this medication and research shows that tizanidine might help improve the sleep quality of the patients with RLS.

RLS is caused by different health conditions and medications and the underlying cause of RLS must be investigated before treatment. If you experience RLS while taking tizanidine, contact your healthcare provider.

References