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Re: Published Research - General Sleep and RLS (WED)

Posted: Mon Jan 08, 2018 8:10 pm
by Rustsmith
I obtained a copy of the paper, but cannot post a link to it. Copyright is owned by Elseveir, who are very difficult to deal with.

But here is a link to the abstract http://www.mayoclinicproceedings.org/article/S0025-6196(17)30825-X/abstract obtained via Google Scholar.

The full paper is really great. Full of scientific details that justify the use of various opioids for the treatment of RLS as well as discussions about why we probably are not subject to issues of addiction.

Re: Published Research - General Sleep and RLS (WED)

Posted: Mon Jan 08, 2018 8:23 pm
by stjohnh
Steve, can individuals buy a copy of the paper? Hmmm. Just clicked on the link, looks like the full paper is there.

Re: Published Research - General Sleep and RLS (WED)

Posted: Mon Jan 08, 2018 9:32 pm
by jul2873
Yes. I just clicked on the "text" button and the link to the PDF came right up. Thanks for the pointer!

Re: Published Research - General Sleep and RLS (WED)

Posted: Mon Jan 08, 2018 10:22 pm
by Polar Bear
Thanks jul2873 and Steve. Great article. The Abstract is helpful to guide a GP who may not have time (at the moment) to read a full document.

Re: Published Research - General Sleep and RLS (WED)

Posted: Fri Jan 12, 2018 5:48 pm
by Rustsmith
This appeared in Frontiers of Neuroscience this month. It is really interesting because they hypothesize that the role of iron issues in the brain is to change the adenosine concentrations and thereby down regulate the adenosine receptors in the brain and that this is what disrupts the dopamine and glutamate levels that cause our symptoms. The abstract is a bit technical, but most of us have probably learned how to read these things at this level by now. The key take away for me is that maybe they are starting to get to the root cause of RLS rather than continuing to just treat "symptoms".

They also report on a small 2 month clinical trial (not double blinded) where 10 out 13 patients given dipyridamole, a med already used to treat stroke patients, produced improvements in both sleep and need to move by acting on improving the adenosine receptors. There are other meds that are also already approved in this same class that might even do better. So, keep you eyes out for new clinical trials.

https://www.frontiersin.org/articles/10.3389/fnins.2017.00722/full

Re: Published Research - General Sleep and RLS (WED)

Posted: Fri Jan 12, 2018 8:16 pm
by ViewsAskew
WOW! Great find, Steve. Thanks for posting.

Re: Published Research - General Sleep and RLS (WED)

Posted: Sat Jan 13, 2018 5:50 pm
by debbluebird
Great!!

Re: Published Research - General Sleep and RLS (WED)

Posted: Sun Jan 14, 2018 12:58 am
by stjohnh
Rustsmith wrote: ... The abstract is a bit technical...

They also report on a small 2 month clinical trial (not double blinded) where 10 out 13 patients given dipyridamole....

https://www.frontiersin.org/articles/10.3389/fnins.2017.00722/full


I just read this article. "A bit technical"... well, maybe for Steve, but very technical and hard to understand for me, but I got the same take away as Steve: understanding the root cause of RLS is within sight, and dipyridamole and similar drugs may be useful in treating RLS. My internist has been very agreeable in allowing me to "experiment" with different meds to help with my symptoms, and I may ask her to let me try dipyridamole. It is cheap, has few side effects, and has been used for decades, just not for RLS.

Re: Published Research - General Sleep and RLS (WED)

Posted: Sun Jan 14, 2018 1:23 am
by Rustsmith
I just read this article. "A bit technical"...


When I wrote that, it was the abstract that I found a "bit technical" (and I admit that I was being a bit facetious with that), the paper on the other hand took several readings, everything that I have learned about neurochemistry and I still had to re-read several sections several times to get what I think that they were trying to say.

And Holland, I was curious what you would have to say about it and was glad to see what you had to say about dipyridamole. It didn't look like it would be too risky, but with anti-coagulants I wanted to hear what someone with a better background had to say.

To me, the fantastic part of it was that they seem to be tying everything that we know about RLS into one neat package. They explain how the iron problem is involved, why we have elevated dopamine and glutamate levels and still benefit from taking dopamine and glutamate like meds, and even why the deep brain stimulation experiments always seem to land on using 100hz to achieve the best relief for RLS. Twenty years ago I was involved in the release of a ground breaking research model in my technical field and this paper has much the same sort of feel. Now, my biggest challenge may be to talk may new GP who is still in residency to let me try an experiment with dipyridamole.

Re: Published Research - General Sleep and RLS (WED)

Posted: Sun Jan 14, 2018 2:05 am
by stjohnh
Rustsmith wrote:
And Holland, I was curious what you would have to say about it and was glad to see what you had to say about dipyridamole. It didn't look like it would be too risky, but with anti-coagulants...

... to talk may new GP who is still in residency to let me try an experiment with dipyridamole.


Hmmm... dipyridamole inhibits platelet aggregation and caution is warranted if a person is taking anticoagulants. Dipyridamole isn't used much anymore because there are more effective antiplatelet drugs. Your doc may have very little knowledge about dipyridamole, and I would be sure to discuss potential bleeding problems, and be sure you and he/she clearly understand the risk.

Re: Published Research - General Sleep and RLS (WED)

Posted: Sun Feb 04, 2018 10:15 pm
by jewelsong
Has anyone seen the 2017 paper by Megelin and Ghorayeb on using medical M.J. for RLS? It is listed in PubMed, but I could not access it ....

Also, many, many thanks to all of you for keeping this Board going. I have spent hours on the boards reading and don’t feel so alone. But am still very discouraged as the methadone leaves me groggy and in a fog for most of every day. Feel like my life is wasting away. When I reduce the dose, I am up all night with symptoms and am even more miserable. (Have tried all the other usual drugs.).

Mmj is legal here and I am using a low dose. Helps some with sleep, but not the PLMs, which I have 24/7, thank you augmentation! Don’t want to be stoned or any groggier than already am, so any new ideas would be welcome. The reference that sent me to this research indicated that they used CBD ...

Blessings,
Marilyn

Re: Published Research - General Sleep and RLS (WED)

Posted: Sun Feb 04, 2018 11:38 pm
by Rustsmith
Has anyone seen the 2017 paper by Megelin and Ghorayeb on using medical M.J. for RLS?


It is a letter to the editor that reports on the experience of six patients. All six had severe RLS (IRLSSG score greater than 30) and were taking or had been taking a dopamine agonist. The results were subjective reports from the patients and all six reported 100% relief, but they didn't say much more than that. So it doesn't say whether this was relief from movement issues or better sleep. Five of the six smoked marijuana and the sixth used some form of sublingual product. Nothing was said about the THC or CBD content or much of anything else about the marijuana used. I don't think that they even said whether the patients were supplied the same MJ or obtained it on their own.

So, there wasn't anything in the letter that you cannot see on this board.

Re: Published Research - General Sleep and RLS (WED)

Posted: Thu Mar 01, 2018 12:01 am
by Rustsmith
[url][/url]The details of the clinical trial to test the adenosine hypothesis with dipryidamole that were published last month have been published online, but have not come out yet in print. The title of the paper is "Treatment of restless legs syndrome/Willis-Ekbom disease with the non-selective ENT1/ENT2 inhibitor dipyridamole: testing the adenosine hypothesis" by Diego Garcia-Borreguero, Xavier Guitart, Celia Garcia Malo, Irene Cano-Pumarega, Juan José Granizo and Sergi Ferré. The article will be published in Sleep Medicine. Here is a link to the abstract, but I could not access the full version (yet).

The abstract doesn't tell us anything new, so we just have to wait a bit longer.

http://www.sleep-journal.com/article/S1389-9457(18)30049-2/abstract

Re: Published Research - General Sleep and RLS (WED)

Posted: Thu Mar 01, 2018 2:56 am
by stjohnh
The abstract does say that the mean dose used was 281 mg at 8 weeks. The med was started at 100mg and up-titrated as needed.

I've been using 112.5mg.

Re: Published Research - General Sleep and RLS (WED)

Posted: Thu Mar 01, 2018 11:05 am
by legsbestill
Thank you, Holland. After a rotten night last night I am glad to see that I am still below the mean dose at 175mg of dipyridamole and will hope for better relief if I go a bit higher.