Apomorphine

[jul2873]

One of my neighbors is a Russian doctor, and her husband has serious RLS. They often visit Israel, and the last time they were there she said her husband was having such a difficult time with the RLS that they went to a neurologist there, and he gave him Apomorphine. She speaks with a heavy accent, but I think she said he was given it as a shot.

She told me it was a drug usually given to people with Parkinson's, so of course I asked if it was a DA. Yes, it is, she said, but it's different than the other ones, and she doesn't think it causes augmentation.

I searched online here, and see only a very few people report using it. I'm still using kratom, and my primary care doc gives me a small supply of oxy for emergency times for me (like when I'm on a long airplane ride or a long car ride). I feel like I'm doing fine with the kratom, and so am not in a hurry to get on a DA. But I had to promise this neighbor doc that I would check out Apomorphine. Her husband has only been on it a few months--and had just come off ropinirole--so, of course, I'm wondering if he augmented on the ropinirole. She didn't seem to worry about augmentation--maybe doesn't know much about it.

Any thoughts anyone? Is it possible there is another DA out there that is great and doesn't cause augmentation?

[Rustsmith]

Apomorphine is a dopamine agonist. It is a non-selective DA, which means that it treats both the D1 and D2 type dopamine receptors. By comparison, the DAs used to treat RLS selectively treat the D3 receptors, which are a subclass of the D2 receptors.

As your neighbor said, apomorphine is primarily used to treat Parkinson's exacerbations. From what I could read, it is not used as a regular treatment for Parkinson's, possibly due to undesirable side effects. I suspect that since it still treats the RLS D2 receptors, it would still cause RLS augmentation if used continually for an extended time and would have the potential of causing other issues since it is a non-specific DA.

[stockton2malone2]

There is a study being done by Dr. Ondo in Houston (I believe I may not have those exact details right) to test apomorphine for RLS patients, so it may be a potential option for us eventually but at the moment there really isn't much evidence one way or the other.