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At least 613 records · Page 34Linked to original sources
PubMed2006

Efficacy and safety of pramipexole in idiopathic restless legs syndrome: a polysomnographic dose-finding study--the PRELUDE study.

BACKGROUND AND PURPOSE: To evaluate the effects of pramipexole (0.125-0.75 mg/d) on polysomnographic (PSG) measures and patient and clinician ratings of restless legs syndrome (RLS). PATIENTS AND METHODS: Patients (n=109) with moderate to severe RLS were randomized to placebo or fixed doses of pramipexole during a 3-week, double-blind, placebo-controlled, dose-finding study. RESULTS: In each pramipexole dose group, the periodic limb movements during time in bed index (PLMI) decreased significantly, compared with placebo (adjusted mean difference in log-transformed data: 0.125 mg, -1.54; 0.25 mg, -1.93; 0.50 mg, -1.89; and 0.75 mg, -1.52; P<0.0001). At all doses, International RLS Study Group Rating Scale (IRLS) scores were also significantly reduced, with the greatest adjusted mean reduction in the 0.50mg group (-17.01). At all but the lowest pramipexole dose, the percentage of responders (> or =50% reduction of IRLS score) was substantially higher than for placebo (61.9-77.3, vs 33.3%). In the pramipexole groups, 50.0-77.3% of patients rated their condition as 'much better' or 'very much better', compared with 38.1% of patients in the placebo group (P=0.0139 for the 0.50 mg dose). Clinical global impressions (CGI) scale ratings of 'much improved' or 'very much improved' were given to 61.9-86.4% of patients in the pramipexole groups, compared with 42.9% in the placebo group (P<0.05 for the 0.25, 0.50, and 0.75 mg groups). Pramipexole was well tolerated and did not produce somnolence at any dose. CONCLUSION: Pramipexole is effective and safe in the treatment of both objective and subjective facets of RLS.

Adult↗
PubMed2000

Diagnosis and management of parasomnias.

Parasomnias are unpleasant or undesirable behavioral or experiential phenomena that occur predominately or exclusively during sleep. These phenomena were initially thought to represent a unitary event, often attributed to psychiatric disease. Recent clinical and polygraphic analysis has revealed that they are, in fact, the result of a large number of very different conditions, most of which are diagnosable and treatable. In fact, most are not the manifestation of psychiatric disorders, and they are far more prevalent than previously suspected. Although there are many parasomnias (1,2), from a practical standpoint only the few that comprise the overwhelming majority will be discussed in this review. These include disorders of arousal, rapid-eye-movement sleep behavior disorder, nocturnal seizures, and restless legs syndrome. Most parasomnias are readily diagnosable and, more importantly, are treatable.

Diagnosis, Differential↗
PubMed2000

Acute abstinence syndrome following abrupt cessation of long-term use of tramadol (Ultram): a case study.

We report on a patient who had taken the centrally acting analgesic tramadol for over 1 year. The compound had proven to be sufficient to treat her painful episodes related to fibromyalgia. Due to lack of supply while being on a trip, intake of the drug was stopped abruptly, resulting in the development of classical abstinence-like symptoms within 1 week. Abstinence-like symptoms consisted of restlessness and insomnia for which the benzodiazepine lorazepam was given. Diarrhoea and abdominal cramps were treated with the peripherally active opioid loperamide, while bouts of cephalgia were treated with sumatriptan. Diffuse musculoskeletal-related pain and restless leg syndrome (RLS) were treated with dextromethorphan. All these different medications proved to be efficacious as they resulted in the cessation of symptoms. Within 1 week symptoms ceased and the patient regained her normal activities without any sequelae. Although tramadol is considered a non-habit- and non-dependence-forming analgesic, abstinence symptoms are likely to develop following abrupt cessation of intake, especially when the compound had been taken over 1 year. Therefore patients should be advised of such an effect whenever they decide to stop intake or their physician is planning to switch to another medication. To avoid abstinence-like symptoms doses should be slowly tapered down.

Acute Disease↗
PubMed2004

Restless legs symptoms among incident dialysis patients: association with lower quality of life and shorter survival.

BACKGROUND: Symptoms of restless legs are common among patients treated with long-term hemodialysis. We investigated the relation between symptoms of restless legs, quality of life, and survival among incident hemodialysis and peritoneal dialysis patients. METHODS: This report includes 894 dialysis patients who responded to an item regarding severity of restless legs symptoms in the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease Study. We examined participant responses both as categorized by the 5-point symptoms of restless legs item and classified with severe symptoms of restless legs if they reported they were very or extremely bothered by symptoms. Independent predictors of restless legs symptoms were estimated using logistic regression. The association of restless legs symptoms with quality of life was examined by means of mixed-model regression, and adjusted mortality risk was estimated by means of Cox proportional hazards. RESULTS: Fifteen percent of dialysis patients were classified as having severe restless legs. Those characterized by severe restless legs were significantly more likely to be administered benzodiazepines, antidepressants, and antiepileptics. Age and diabetes mellitus were independently associated with severe symptoms of restless legs. Symptoms of restless legs were associated with lower Physical and Mental Component Scores, vitality, bodily pain, and sleep quality (all P < 0.001). After adjustment, severe symptoms of restless legs were significantly associated with an increased mortality hazard ratio of 1.39 (95% confidence interval, 1.08 to 1.79). CONCLUSION: Symptoms of restless legs were associated with lower quality of life and increased risk for death. The effect of treatment for symptoms of restless legs on quality of life and survival awaits additional study.

Adult↗
PubMed1997

Mianserin and restless legs.

Six cases of restless legs syndrome in association to mianserin are presented. Similarities and differences to previously reported cases are described. Some theoretical and methodological topics on restless legs syndrome in relation to drug-induced akathisia are discussed.

Adult↗
PubMed2003

Restless legs syndrome: a case study.

Restless legs syndrome (RLS) is a sensory motor neurological movement disorder affecting 12 million Americans. Few healthcare providers know of the existence of this syndrome. Often underdiagnosed and unrecognized because of comorbid conditions, RLS is a lifelong condition with worsening symptoms. For the healthcare provider, RLS may present with confusing symptoms. With no cure, treatment is often unsuccessful in alleviating the discomfort associated with the syndrome. Although RLS is a common, potentially disabling condition, neuroscience nurses may provide interventions to assist in the successful management of the syndrome.

Adult↗