Refractory Restless Legs Syndrome Likely Caused by Olanzapine

Association of Restless Legs Syndrome With Incident Parkinson’s Disease

“…7 Therefore, neuroleptics, drugs that block dopamine receptors may cause or exacerbate symptoms of RLS. Based on a few case reports of neuroleptic-induced RLS, [47][48][49][50][51][52][53][54] the interaction between neuroleptic use and RLS should be recognized and taken into account, although the quality of some of this data has been questioned 55 and has provided conflicting results. [56][57][58] In our study, neuroleptic use at baseline was not associated with higher risk of prevalent RLS.…”

Restless legs syndrome due to aripiprazole

“…Aripiprazole and olanzapine are atypical antipsychotics, acting as partial agonist and antagonist of the dopamine D 2 receptor, respectively. Aripiprazole has not been associated with RLS in other case reports (6)(7)(8) , where antidepressants and antipsychotics induced RLS and it is the first singularity distinguished this case. In theory the difference in the mechanism of action may explain why RLS was not seen with aripiprazole.…”

“…Dopamine antagonist have been shown to exacerbate RLS and the second particularity is the absence of RLS related with olanzapine like others case reports (6,7) when the symptoms resolved after this drug was discontinued.…”

“…The RLS diagnostic is clinical and the 4 criteria are: (1) the patient must have an urge to move the legs; (2) symptoms must be aggravated by rest; (3) symptoms must be alleviated by movement, especially by walking; and (4) symptoms must be worse in the evening or night (circadian rhythm) (4,5) . This syndrome may be the result of dopamine and iron system abnormalities and the role on RLS pathophysiology has been supported by demonstrated therapeutic benefit, although these relationships are not fully understood (6)(7)(8) .…”

The Psychopharmacological Management of RLS in Psychiatric Conditions

“…When dosages were decreased or discontinued, all symptoms of RLS stopped. Findings of the effects of antipsychotics and the onset of RLS symptoms are seen with olanzapine (Zyprexa; Kang, Lee & Kim, 2009; Khalid, Rana, Khalid & Roehrs, 2009; Kraus et al, 1999), haloperidol (Haldol; Horiguchi et al, 1999), risperidone (Risperdal; Wetter, Brunner, & Bronisch, 2002), quetiapine (Seroquel; Pinninti, Mago, Townsend & Doghramji, 2005; Urbano & Ware, 2008), and clozapine (Clorazil; Duggal & Mendhekar, 2007). Fortunately, as reported in Table 1, the symptoms of RLS that are induced by antipsychotics are usually reversible once the medications have been discontinued or the dosage has been decreased.…”