Randomized, Double-Blind, Placebo-Controlled Study of Clonidine in Restless Legs Syndrome

Wagner, Mary L.; Walters, Arthur S.; Coleman, Rob; Hening, Wayne A.; Grasing, Kenneth; Chokroverty, Sudhansu

doi:10.1093/sleep/19.1.52

Cited by 32 publications

(2 citation statements)

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“…Clonidine has been reported in multiple studies as showing effective results in treating RLS. One study reported that the use of clonidine (mean = 0.05 mg/day) is useful in patients who experience delayed sleep onset due to leg sensations [ 19 ]. The study showed that clonidine decreased rapid movement sleep pattern (REM) sleep and increased REM latency, but did not change total sleep duration, stage 1 and 2 sleep, sleep efficiency, awakenings, arousals, or periodic limb movements in sleep.…”

Section: Discussionmentioning

confidence: 99%

Does Dexmedetomidine Improve or Worsen Restless Leg Syndrome under Sedation: A Case Report and Extensive Review

Iskandar

Martins

Hudson³

et al. 2022

Case Reports in Critical Care

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Background. Restless leg syndrome (RLS) is a common neurological condition that manifests as creeping, nonpainful urges to move lower extremities and is relieved with movements of the legs. RLS is associated with comorbidities such as gastric surgery, diabetes mellitus, uremia, and iron deficiency anemia, and it is misdiagnosed in many cases. Drugs like levodopa, ropinirole, pramipexole, cabergoline, and pergolide that target the dopaminergic system have been traditionally used to treat symptoms of RLS. α2-adrenoceptor (α2-AR) agonists, like clonidine and dexmedetomidine, have also been reported to show improvement of RLS symptoms during sedation. Specific Aim. This case report suggests that dexmedetomidine may have worsened RLS during sedation in a 71-year-old male with no prior diagnosis of RLS or reported symptoms. The patient had a procedure for right first metatarsophalangeal joint (MTPJ) fusion, with second digit proximal interphalangeal joint (PIPJ) arthrodesis, and flexor tendon transfer due to pain on walking and failing conservative therapy. He underwent intravenous sedation/monitored anesthesia care (MAC) with propofol, dexmedetomidine, and a peripheral regional block for intraoperative anesthesia and postoperative analgesia. During the surgery, the patient experienced continuous bilateral leg movement, unpredictable, and unrelated to surgical stimulation or level of consciousness within 5 minutes of administration of dexmedetomidine. The patient tolerated the procedure, and the unpredicted leg movement was managed by the surgeons intraoperatively. Conclusion. Although no previous literature exists and mechanisms are unclear, this case report hypothesizes that dexmedetomidine may contribute to worsening RLS symptoms.

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Section: Discussionmentioning

confidence: 99%

Does Dexmedetomidine Improve or Worsen Restless Leg Syndrome under Sedation: A Case Report and Extensive Review

Iskandar

Martins

Hudson³

et al. 2022

Case Reports in Critical Care

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“…18 Benzodiazepines are also commonly used for treating RLS. 19 Less frequently used medications (Table 1), targeting different regions of interest, include the alpha-adrenoceptor 2A agonist clonidine, [40][41][42][43][44][45][46] the adenosine transporter inhibitor dipyridamole, 3,[47][48][49] the N-methyl-D-aspartate receptor antagonists amantadine 50 and ketamine, 51 corticosteroids (hydrocortisone 52 and oral prednisolone 53 ), cannabinoids, 54,55 etc.…”

mentioning

confidence: 99%

Anticonvulsant Agents for Treatment of Restless Legs Syndrome

Al-Kassmy,

Alsalmi,

Kang

et al. 2024

The Neurologist

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Introduction: Restless Legs Syndrome (RLS) is a neurological disorder primarily treated with pregabalin and gabapentin, followed by dopamine agonists later in the process due to the risk of augmenting RLS symptoms. In addition, clinical reports have disclosed varying degrees of success employing other agents in patients unresponsive to traditional agents. Here, we present a patient who had success in the reduction of RLS symptoms with lamotrigine, a broad-spectrum anticonvulsant. Previously, lamotrigine had been used in 2 trials with successful treatment of RLS. Case Report: We present a 58-year-old right-handed lady with long-standing history of smoking, hypertension, dyslipidaemia, prediabetes, gastro-esophageal reflux disease, asthma, strabismus, uterine cancer, severe and debilitating course of RLS accompanied by unexplained deterioration. The patient initially demonstrated abnormal sensation in all her limbs, which worsened with radiotherapy treatment, and was eventually diagnosed with RLS based on the diagnostic criteria. Subsequent examinations were unremarkable and revealed no further explanation for the deterioration of the RLS symptoms. While the complexity of the patient’s medical history had exposed her to a variety of medications, she reported that only lamotrigine, in addition to her original regimen of methadone and pramipexole, offered significant symptomatic relief. It must be noted that no adverse side effects, including impulse-control disorder, were reported by the patient. Conclusions: We present a case of a woman whose deteriorating symptoms of RLS were successfully alleviated by the administration of lamotrigine. This is only the third case in the literature to have successfully utilized lamotrigine as a treatment option for RLS.

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Restless legs and periodic leg movements in sleep syndromes

Wetter

Pollmächer

1997

J Neurol

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Randomized, Double-Blind, Placebo-Controlled Study of Clonidine in Restless Legs Syndrome

Cited by 32 publications

References 0 publications

Does Dexmedetomidine Improve or Worsen Restless Leg Syndrome under Sedation: A Case Report and Extensive Review

Does Dexmedetomidine Improve or Worsen Restless Leg Syndrome under Sedation: A Case Report and Extensive Review

Anticonvulsant Agents for Treatment of Restless Legs Syndrome

Restless legs and periodic leg movements in sleep syndromes

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