# Intersecting Pathways: Treating Cocaine Withdrawal and Restless Leg Syndrome with Iron and Buproprion

## TL;DR

A 63-year-old man with cocaine use disorder and restless leg syndrome improved after iron and bupropion treatment, suggesting a link between iron deficiency and these conditions.

## Contribution

This case report suggests that iron supplementation and bupropion may alleviate cocaine withdrawal and restless leg syndrome symptoms.

## Key findings

- The patient's mood, cravings, and RLS symptoms improved with iron supplementation and bupropion.
- Iron deficiency may contribute to dopamine-related disorders like cocaine withdrawal and RLS.
- Further research is needed to validate iron's role in treating addiction and RLS.

## Abstract

Many drastic actions are taken by cocaine users for the sake of experiencing high levels of dopamine, which depends on iron for its synthesis. Dopamine depletion and iron deficiency are also involved in the symptoms of restless leg syndrome (RLS). The intersecting biochemical pathways of cocaine use, iron deficiency, and RLS have not been adequately investigated. This case report reveals the successful treatment of a patient experiencing these conditions. A 63-year-old male with a history of cocaine use disorder, insomnia, and RLS sought emergency care for suicidality. Upon admission, he was also found to be iron deficient. He revealed that his RLS worsened when he attempted to abstain from cocaine. He also used alcohol to sustain the effects of cocaine when the cost of cocaine was too high. During hospitalization, his mood, cravings, and RLS were resolved with adjunctive iron supplementation, as well as treatment with 300 mg of Wellbutrin (bupropion hydroxychloride). If iron deficiency is present, the replenishment of the adequate dopaminergic receptor density and function via supplementation may play an essential role in the prevention of cocaine use and the cessation of cocaine withdrawal symptoms. Further research is warranted to validate these findings and to investigate the implications of iron supplementation in addiction medicine.