Restless Legs Syndrome (RLS) Discussion Board

Those of you who've seen the March eFriends newsletter will have seen this, but I thought I would post it here because someone is finally looking at how to treat augmentation. I feel leery about messing with dopamine receptors to fix a problem caused by messing with dopamine receptors, but I'm very interested in what they find out.

Grant Awarded for Augmentation Treatment Testing

The RLS Foundation has awarded a $37,000 research grant for "Treatment of RLS Augmentation with Ecopipam, A D1 Specific Antagonist" to William G. Ondo, MD, of Houston Methodist Neurological Institute. This small clinical trial will evaluate the effectiveness of ecopipam in reversing the symptoms of augmentation, a common side effect of dopamine medications. Dr. Ondo is director of the RLS Quality Care Center at Houston Methodist, and a member of the RLS Foundation Scientific and Medical Advisory Board. Watch for more information on the study coming soon.

This is great news and an indication of the work done by the Foundation.
Pretty good that it is under the direction of Dr Ondo.

I sort of wish this had happened 2 years ago while I was one of Dr Ondo's patients and was augmented for the second time. I would have been a perfect candidate for the study and the results probably couldn't have been any worse than the year of augmentation that I ended up going through.

badnights wrote:The RLS Foundation has awarded a $37,000 research grant for "Treatment of RLS Augmentation with Ecopipam, A D1 Specific Antagonist" to William G. Ondo, MD, of Houston Methodist Neurological Institute. This small clinical trial will evaluate the effectiveness of ecopipam in reversing the symptoms of augmentation, a common side effect of dopamine medications.

I'm unfamiliar with this process...is it likely that Ecopipam has already shown promise and that is why it is being studied?

I think it is based on research that the D2 receptor is the one responsible for augmentation - and the common DAs all hit D2. I read his proposal a week or so and that is what I remember at any rate!

yawny, there isn't any info along those lines in the proposal, but this sort of thing is generally something that comes out of a combination of animal studies and prior knowledge of how existing meds work. Therefore, I wouldn't jump to the conclusion that it is already showing promise with treating augmentation, but it probably does mean that if they got all the approvals required for clinical trials that it shows promise.

Steve is right. In this particular case, as I understand it, they are thinking sort of as Ann said, of what is known about WED/RLS and what is known about the substance they want to test.

First, they know that the dopamine agonists (DAs) that affect RLS/WED activate all three varieties of dopamine receptors - D1, D2, and D3. They also know, from studying mice, that the number of D1 receptors increases from a steady diet of DAs, so they figure that might be the cause of augmentation. Finally, they know (from multiple studies on animals, I imagine) that the suite of actions resulting from stimulation of D1 receptors includes some actions that are in direct opposition to actions resulting from D2 stimulation; so the DA medications that stimulate both receptors cause conflicting actions, which supports the notion that D1 over-activation causes augmentation.

So they looked for a drug that would antagonize - block or otherwise de-activate and prevent the proliferation of - D1 receptors. I don't know how this search was carried out, but it led them to ecopipam.

They will now try it on humans who are taking a DA and have augmented, to see if the drug helps the symptoms of augmentation.

The DAs worked so well for me ... until they didn't. It would be a dream come true if I could take them without fear of augmentation.