Published Research - Pharmaceutical

Use this section to discuss your experiences with prescription drugs, iron injections, and other medical interventions that involve the introduction of a drug or medicine into the body. Discuss side effects, successes, failures, published research, information about drug trials, and information about new medications being developed.

Important: Posts and information in this section are based on personal experiences and recommendations; they should not be considered a substitute for the advice of a healthcare provider.
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ViewsAskew
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Post by ViewsAskew »

This is a very interesting site - focused on Chronic Fatigue, Fibro, etc.

This study was about whether ADs worsened RLS. Interesting results that we should all know about if we're ever in the need of one:

http://dfwcfids.net/index.php?option=co ... Itemid=165

Restless Legs Syndrome as Side-Effect of Second Generation Antidepressants

Written by Rottach KG, et al
Saturday, 24 May 2008

Although of clinical interest, the question is still not fully answered whether antidepressants (AD) can cause or exacerbate restless legs syndrome (RLS). The literature provides contradictory information.
This study addresses this problem for the class of second generation AD. In four neurological offices, all patients treated for the first time with an AD were prospectively observed with regard to the question of whether RLS occurred, or pre-existing RLS worsened as a result of the medication.

Because initial treatment in the participating offices is mainly executed with "modern" selective AD, the study was restricted to these drugs:

fluoxetine,
paroxetine,
citalopram,
sertraline,
escitalopram,
venlafaxine,
duloxetine,
reboxetine, and
mirtazapine.


Key Points:
In 9% of patients, RLS was recorded as a side effect related to the administration of AD. The frequency of this side effect varied among the drugs.
Typically, RLS occurred during the initial days of treatment.
The problem is most pronounced with mirtazapine [most common brand name RemeronR] provoking or deteriorating RLS in 28% of patients.
By contrast, no case occurred during use of reboxetine [brand names EdronaxR and others].
As for the other AD, the rate of newly occurred and deteriorated RLS ranged from 5% to 10%.

PMID: 18468624
Source: Restless Legs Syndrome as Side-Effect of Second Generation Antidepressants. Journal of Psychiatric Research, May 9, 2008. [Epub ahead of print]


Authors and Affiliations: Rottach KG, Schaner BM, Kirch MH, Zivotofsky AZ, Teufel LM, Gallwitz T, Messer T. Gonda Brain Research Center, Bar Ilan University, Ramt Gan, Israel; Bezirkskrankenhaus Augsburg, Clinic for Psychiatry and Psychotherapy, Augsburg, German
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Post by ViewsAskew »

WOW! This is another great clue regarding the RLS puzzle. Thanks Drs Early, Allen, Connor and the rest. Early and Allen are tireless in the research world...I am sure the others are, too, but I haven't met them...

http://www.journalsleep.org/ViewAbstrac ... ionid=3577

Altered Iron Metabolism in Lymphocytes from Subjects with Restless Legs Syndrome Volume : 31
Issue : 06
Pages : 847-852

--------------------------------------------------------------------------------

Christopher J. Earley, MB, BCh, PhD, FRCPI1; Padmavathi Ponnuru, PhD2; Xinsheng Wang, MD, PhD2; Stephanie M. Patton, PhD2; James R. Connor, PhD2; John L. Beard, PhD3; Dennis D. Taub, PhD4; Richard P. Allen, PhD1

1Department of Neurology, Johns Hopkins University, Baltimore, MD; 2Department of Neurosurgery, Penn State College of Medicine, Hershey, PA; 3Department of Nutritional Sciences, Penn State University, University Park, PA; 4Laboratory of Immunology, Gerontology Research Center, NIH/NIA, Baltimore, MD




Objective:

Studies using cerebrospinal fluid, magnetic resonance imaging, and autopsy tissue have implicated a primary role for brain iron insufficiency in restless legs syndrome (RLS). If the abnormalities of brain iron regulation reflect a basic disturbance of iron metabolism, then this might be expressed at least partially in some peripheral systems. Thus the study aim was to determine whether patients with RLS and control subjects show differences in lymphocyte iron regulator proteins.

Methods:

Fasting morning blood samples were used to obtain common serum measures of iron status and to determine lymphocyte iron management proteins. Twenty-four women with early-onset RLS and 25 control women without RLS symptoms were studied.

Results:

RLS and control subjects were matched for age, hemoglobin, and serum iron profile. However, transferrin receptor (TfR) and DMT1 (divalent metal transporter 1 protein) levels in lymphocytes were significantly higher for RLS patients than for controls. No significant differences in ferritin subtypes or transferrin levels were found. No significant correlations were found between lymphocyte and serum indices of iron status.

Interpretation:

RLS lymphocytes showed an increase in ferroportin, implying increased cellular iron excretion, in the face of increased iron need (increased TfR and DMT1). In the absence of changes in H-ferritin, the findings indicate a balance between input and output with no net iron change but probable overall increase in iron turnover. The lack of any significant correlation between serum and lymphocyte iron indices indicates that iron management proteins from lymphocytes are at a minimum an alternative and independent marker of cellular iron metabolism.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

cornelia

Post by cornelia »

I agree Ann, these researchers are the best! Can you explain what this means in layterms?

Corrie

ViewsAskew
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Post by ViewsAskew »

They just know more about how the iron deficiency. Lymphocytes are white blood cells and there were looking at certain proteins to see if anything about these were different between RLS patients and non-RLSers.

They found a difference that appears to be responsible for a reduction in ferritin and may explain why after an infusion, we have a 2 to 10 times greater loss of iron (than is expected). Since there is no blood loss in patients with RLS who have transfusions, they couldn't figure out where the iron was going - what was causing it to be recued? Now they may have a reason because of how these lyphocytes are functioning.

I found the full version of the study last night, too: http://www.journalsleep.org/AcceptedPap ... 055407.pdf
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

FidgetBoy
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Post by FidgetBoy »

Very interesting!! Now I want someone to do some research about what level of ferritin we need to have to make up for this deficiency... or a study showing how much iron we need to take? My levels have always been within range....
Josh

cornelia

Post by cornelia »

Ann, thanks, you're the best. I understand now (I think).

My ferritin went up from 11 to 290 within a few years: it did nothing for my symptoms. So....

Corrie

ViewsAskew
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Post by ViewsAskew »

It may not solve the problem (increasing ferritin) alone - they don't have all the puzzle pieces. This piece of the puzzle gives a possible reason why the ferritin decreases so rapidly and we can't seem to keep it in our bodies very well. It doesn't say how to resolve that or if there are additional pieces of the puzzle that cause other problems.

But, to me, it's the best news because it shows that these tireless advocates for RLS are working hard at resolving it. That gives me hope.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Post by ViewsAskew »

http://advancedcognitivepsychology.blog ... ation.html

Not to diminish or make fun or this person's experience, but wow....since my experience was sooooo far to the other side, I can't but wish there had been a middle ground here.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

FidgetBoy
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Post by FidgetBoy »

wow.... makes me glad I got off those drugs when I did. I don't have enough time in the day for that type of activity! :roll:
Josh

Hos
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Post by Hos »

Very strange. I guess it could be true with the libido since the brain is being altered so who know how it'll affect the next person. Like anything in LIFE though, there could be other factors maybe not mentioned in the study that caused him to become a crazy ...jerk.

ViewsAskew
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Post by ViewsAskew »

This was another topic that came up in the Regional meeting today. This is very real - the problems with the dopamine agonists (and not carbidopa/levadopa) tend to fall into gambling, shopping, sexual, and eating compulsions. Dopamine is a strong, strong, strong neurotransmitter and it's very hard to overcome the limbic brain when it's telling you that you MUST eat that donut, play one more hand of poker, satisfy your sexual desires, or buy that lovely ring or necklace that will look so lovely on you or your loved one.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Post by ViewsAskew »

This story has an interesting perspective about Requip and the new RLS drug from GSK.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Post by ViewsAskew »

We've been following this drug for awhile now; it seems it's doing well in trials. Wonder how augmentation is affected by it...
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Post by ViewsAskew »

One of the drugswe've been following has now been granted a European patent. I don't know what that means, but I suspect we'll be seeing it, at least in Europe, within some reasonable time frame.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Post by ViewsAskew »

Huh, don't think I've heard of this new drug. But I know I'm sure glad to see something new in the pipeline. I wish this one success. If so, we'll be seeing it in 7-15 years.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

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