Restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) Acute placebo-controlled sleep laboratory studies with clonazepam

@article{Saletu2001RestlessLS,
  title={Restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) Acute placebo-controlled sleep laboratory studies with clonazepam},
  author={Michael T Saletu and Peter Anderer and Gerda Maria Saletu-Zyhlarz and Wolfgang Prause and Brigitte Semler and Ali Zoghlami and Georg Gruber and Catharina Hauer and Bernd Saletu},
  journal={European Neuropsychopharmacology},
  year={2001},
  volume={11},
  pages={153-161}
}
While Isolated Periodic Limb Movement Disorder Significantly Impacts Sleep Depth and Efficiency, Co-Morbid Restless Leg Syndrome Mainly Exacerbates Perceived Sleep Quality
TLDR
Sleep structure and efficiency were similarly impacted in isolated PLMD and in co-morbid RLS, and such results may question whether no or different-from-RLS treatment strategies are compatible with optimal care.
Periodic leg movements and restless legs syndrome
TLDR
Goal-directed addition of dopaminergic agents or the reduction of neuroleptic drugs results in lower PLM indices and improved subjective sleep quality and loweredPLM indices in patients with persistent sleep disturbances.
Acute placebo-controlled sleep laboratory studies and clinical follow-up with pramipexole in restless legs syndrome
TLDR
In a single-blind, placebo-controlled crossover trial, acute pramipexole markedly reduced PLM measures and slightly improved objective and subjective sleep quality and the psychopathological findings are reminiscent of those seen after activating antidepressants.
Controlled clinical, polysomnographic and psychometric studies on differences between sleep bruxers and controls and acute effects of clonazepam as compared with placebo
TLDR
As compared with placebo, clonazepam significantly decreased the SB index in all patients, and sleep efficiency, maintenance, latency, awakenings and nocturnal wake time, the stage shift index, S1, PLM, the arousal index, subjective sleep and awakening quality, and fine motor activity improved.
Current treatment options for restless legs syndrome
TLDR
Treatment of RLS is generally symptomatic, a causal therapy is possible only in the secondary forms and opioids and anticonvulsants such as gabapentin or benzodiazepines, are regarded as second-line treatment, although dopaminergic drugs may also be helpful.
Treatment of Restless Legs Syndrome
  • C. Comella
  • Medicine, Psychology
    Neurotherapeutics
  • 2013
Restless legs syndrome (RLS) is a common disorder diagnosed by the clinical characteristics of restlessness in the legs associated often with abnormal sensations that start at rest and are improved
Restless legs syndrome: pathophysiology, clinical presentation and management
TLDR
Iron deficiency must be identified and treated by supplementation, both to improve RLS symptoms and to potentially lower the risk of augmentation.
EFNS guidelines on management of restless legs syndrome and periodic limb movement disorder in sleep
TLDR
The following level A recommendations can be offered: for primary RLS, cabergoline, gabapentin, pergolide, ropinirole, levodopa and rotigotine by transdermal delivery are effective in relieving the symptoms.
Movement disorders: A sleep specialist’s perspective
Article abstract—This review focuses on restless legs syndrome (RLS) and Parkinson’s disease (PD). These conditions are frequently encountered in clinical sleep medicine and are among the most
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Sleep Laboratory Studies in Restless Legs Syndrome Patients as Compared with Normals and Acute Effects of Ropinirole
TLDR
0.5 mg ropinirole significantly improved the target variable PLM/h TST, along with objective and subjective sleep quality and morning noopsychic performance, as described in the preceding paper.
Sleep Laboratory Studies in Restless Legs Syndrome Patients as Compared with Normals and Acute Effects of Ropinirole
TLDR
A key-lock principle in the diagnosis/treatment of RLS and a dopaminergic mechanism in its pathogenesis is suggested, supported by the data on periodic leg movements during sleep and arousals of the subsequent paper.
Sleep laboratory studies in periodic limb movement disorder (PLMD) patients as compared with normals and acute effects of ropinirole
TLDR
Ropinirole 0.5 mg was shown to significantly improve the index PLM/hTST by 64% and arousals due to PLM, increase spontaneous arousals, REM‐latency, stage 2 and stage shifts and decrease SREM, which suggests a dopaminergic pathogenesis in PLMD.
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It is concluded that both CBT and clonazepam therapies may be useful for PLMD but that the two treatments may have contrasting effects across selected measures of improvement.
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A task force consisting of six authors reviewed the published literature on the therapy of the restless legs syndrome or periodic limb movements in sleep available in indices through April, 1998.
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Alprazolam induced changes that were opposite to the differences observed between patients and controls before treatment, thereby normalizing sleep and awakening quality, points to a key‐lock principle in the treatment of insomnia caused by anxiety disorders and neurophysiologically visualizes processes at the receptor level.
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TLDR
It was concluded that 0.125 mg triazolam, when used for up to 3 months, could improve sleep and daytime function in older patients with periodic leg movements, fragmented sleep, and daytime sleepiness.
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TLDR
A combination therapy of rr-l-dopa and sr-l -dopa is better than monotherapy with rr -l-Dopa in reducing the frequency of PLM and problems maintaining sleep, even in patients who are severely affected.
Toward a better definition of the restless legs syndrome
TLDR
Features commonly seen in RLS include sleep disturbance, periodic limb movements in sleep and similar involuntary movements while awake, a normal neurological examination in the idiopathic from, a tendency for the symptoms to be worse in middle to older age, and, in some cases, a family history suggestive of an autosomal dominant mode of inheritance.
Insomnia in generalized anxiety disorder: polysomnographic, psychometric and clinical investigations before, during and after therapy with a long- versus a short-half-life benzodiazepine (quazepam versus triazolam).
TLDR
Sleep efficiency improved after acute administration of both drugs, but the improvement was maintained by quazepam only, and anxiety improved significantly with both drugs and remained improved throughout 2 weeks post-drug placebo, with quzepam being slightly superior to triazolam.
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