Abstract
Dopaminergic agents and carbidopa/levodopa have become the preferred treatment for both the restless legs (RL) syndrome and for periodic limb movements in sleep (PLMS). For once-nightly treatments with carbidopa/levodopa, a problem with morning end-of-dose rebound increases in leg movements has been reported to occur in the about one fourth of the patients. In our clinical studies a previously unreported but far more significant problem of markedly augmented RL symptoms occurred in the afternoon and the evening prior to taking the next nightly dose. A systematic prospective evaluation of this augmentation in 46 consecutive patients treated with carbidopa/levodopa for RL syndrome or PLMS disorder found this augmentation to be the major adverse effect of treatment. Augmentation occurred for 31% of PLMS patients and 82% of all RL patients. It was greater for subjects with more severe RL symptoms and for patients on higher doses (≥50/200 mg carbidopa/levodopa) but was unrelated to gender, age or baseline severity of PLMS. This augmentation was severe enough to require medication change for 50% of the RL patients and 13% of PLMS patients. Augmentation resolved with cessation of the medication and could be minimized by keeping the dose low.
Original language | English (US) |
---|---|
Pages (from-to) | 205-213 |
Number of pages | 9 |
Journal | Sleep |
Volume | 19 |
Issue number | 3 |
DOIs | |
State | Published - 1996 |
Keywords
- Carbidopa
- Dopaminergic agents
- Levodopa
- Periodic limb movements in sleep
- Restless legs syndrome
ASJC Scopus subject areas
- Clinical Neurology
- Physiology (medical)