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Old 12-23-2006, 02:02 AM
Lara Lara is offline
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Join Date: Sep 2006
Posts: 10,984
15 yr Member
Lara Lara is offline
Legendary
 
Join Date: Sep 2006
Posts: 10,984
15 yr Member
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I have RLS.
Actually that article is quite interesting from my point of view. Apart from the fact that it references some of Roger Kurlan's work, I find it interesting for a few other reasons. Kurlan is a member of the Tourette Syndrome Association Medical Advisory Board. The acticle referenced speaks about 2 patients who found that they developed tolerance or declining response to the medications and suggestions about improving that. (as an aside, I see that Kurlan has also written a paper regarding "dopamine phobia" in patients who have Parkinson's Disease.)

I've personally never taken any pharmaceutical medications for my RLS although I can assure you that I've been tempted at times when I've wanted to jump of a cliff to stop the edginess and restlessness, and I mean that quite seriouslly. Because it sounds like a fairly painless syndrome because of the name, it's actually something quite dreadful and I have much empathy for anyone who has this problem.

I have a few minor motor tics. One major observation that I've found over the years since my childhood has been that my RLS is much worse at the times when I have no tics, and visa versa. Obviously related to dopamine dysregulation, but I'd hate to think what would happen if I started using a dopamine agonist for RLS or even a dopamine antagonist for the tics, although that wouldn't happen.

I have also noticed in the past few years though, that some doctors have treated patients who have debilitating tics with some low dose dopamine agonists although it isn't that common a practice.

Quote:
J Gen Intern Med. 2006 Dec;21(12):C1-4.
Medication tolerance and augmentation in restless legs syndrome: the need for drug class rotation.

* Kurlan R,
* Richard IH,
* Deeley C.

Movement Disorders Unit, Department of Neurology, University of Rochester School of Medicine, Rochester, NY, USA.

Restless legs syndrome (RLS) is a common condition characterized by an unpleasant urge to move the legs that usually occurs at night and may interfere with sleep. The medications used most commonly to treat RLS include dopaminergic drugs (levodopa, dopamine agonists), benzodiazepines, and narcotic analgesics. We report the cases of 2 patients with RLS who illustrate the problems of tolerance (declining response over time) and augmentation (a worsening of symptoms due to ongoing treatment) that can complicate the pharmacotherapy of RLS. We discuss the optimal management of RLS and propose strategies to overcome tolerance and augmentation such as a rotational approach among agents from different classes.

PMID: 17105517 [PubMed - indexed for MEDLINE]

Last edited by Lara; 12-23-2006 at 02:10 AM. Reason: Had something back to front.
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