Restless Leg Syndrome and Requip, the Antipsychotic Drug and its Side Effects

Restless Leg Syndrome (also known as Ekbom Syndrome) is a condition where you have an urge to move your legs, usually accompanied or caused by uncomfortable and unpleasant leg sensations (often described as nervousness or a creepy-crawling sensation); symptoms begin or worsen during periods of rest or inactivity such as lying or sitting; symptoms are partially or totally relieved by movement such as walking or stretching at least as long as the activity continues; and symptoms are worse or occur only in the evening or night.  Difficulty falling asleep may frequently be associated with moderate-to-severe RLS.  In severe cases pounding of the legs and kicking your partner while sleeping can also occur.

 

My symptoms popped up long before all the ads on television.  I had no idea what to do for my symptoms.  I just knew that late in the evening when I sat down to watch television that my legs felt very nervous.  Then one evening I awaked suddenly after kicking my husband very hard.  I had been sleeping on my side and my leg just kicked up on its own.  It was a big joke for awhile.  On a separate occasion my husband said that I had been pounding the bed with my legs very hard while sleeping on my back.

 

I had no idea what this was and thought I was really losing it, as I had other symptoms that I could not explain.  So I just caulked it up to being all one big mystery.  I was able to find out about RLS online, but no one had any suggestions on how to relieve the symptoms.

 

Then one day while I was at a doctor’s visit I brought this up because my symptoms seemed to be moving into my arms.  By this time REQUIP was just starting to be advertised on television.  I asked my MD what the ad on television was all about for REQUIP.  He didn’t explain it, but wrote me out a prescription and was glad that I was willing to give it a try.  I told him I would research it first.  I went to the pharmacy and had it filled, figuring I would search online and find out more about it before taking it.  Before I left the pharmacy someone explained the medication to me since it was a new prescription.  She assumed I had Parkinson’s Disease.  I told her, “No!”  She didn’t understand why my doctor would prescribe such a drug for Restless Legs because it was such a heavy drug.  She further explained the side effects.  I already had most of those symptoms and didn’t need to have them get worse.  She suggested I not take it.

 

I used to take a mixture of Calcium and Magnesium to help me sleep at night and I had not been taking it for some time. One night my husband suggested that I take it to see if it would help my RLS (since it is also used in relaxing muscles after exercise, etc.)  I tried it and all of my symptoms disappeared.  My symptoms would creep back up again every third night or so.  (If you take too much magnesium it can cause loose stool.)  So I just took it about every second or third night and it did the trick.  I haven’t had any symptoms since unless I went over a week or so without any calcium and magnesium.  By the way, I use a powder form called CalMax.  You just mix it with boiling water.

 

According to some reports, patients have been treated with Risperidone, sold under the trade name Risperdal (an antipsychotic drug) which can make you do crazy things.  My mother was prescribed this drug for her dementia due to Alzheimer’s and after being on the drug for only 3 days she started hording sugar packs and all sorts of food and things.  It was sad.  Once she got off Risperidone she was back to her usual forgetful self.

 

Finally I was diagnosed with hyperthyroidism (an over active thyroid).  I refused their medications for this as well and addressed all the stress in my life, mainly my job and now my thyroid is functioning normally, too!  Can you imagine if I had taken the prescription for REQUIP and became a zombie?  (See side effects at the bottom of this article.  It is shocking!)  The drug would have probably masked my hyperthyroid symptoms and I would have never known what to address!

 

So, the rule of thumb is research your prescriptions before taking them.  I do not know any safe psychiatric drug.  They are all mind altering drugs. 

 

Following are the abbreviated results of a 2 year study performed by the manufacture of REQUIP (I have defined most of the medical terms).  Please read below for details.  The side effects include, but are not limited to: Melanoma (the most serious type of skin cancer); worsening of RLS and other involuntary movements; drowsiness; confusion; Neuroleptic Malignant Syndrome (a response to neurological drugs) characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability (the nervous system that regulates many important body functions while we sleep); fibrous tissue growing in or around organs and tissue; symptoms appearing in early morning; compulsive behaviors such as hypersexuality and gambling; hypotension, (meaning dizziness with very low blood pressure); unusual behavior such as developing an ediction of any kind; hallucinations; dangerously low blodd pressure and birth defects.

 

Information for Patients:

 

Patients should be advised that they may develop postural (also known as orthostatic) hypotension, (meaning dizziness with very low blood pressure) with or without symptoms such as dizziness, nausea, partial or complete loss of consciousness, and sometimes sweating. Hypotension and/or orthostatic symptoms may occur more frequently during initial therapy or with an increase in dose at any time even after weeks of treatment. Accordingly, patients should be cautioned against rising rapidly after sitting or lying down, especially if they have been doing so for prolonged periods, and especially at the beginning of treatment with REQUIP.

 

Patients should be alerted to the potential sedating effects associated with REQUIP, including somnolence (the state of feeling drowsy) and the possibility of falling asleep while engaged in activities of daily living. Since somnolence is a frequent adverse event with potentially serious consequences, patients should neither drive a car nor engage in other potentially dangerous activities until they have gained sufficient experience with REQUIP to gauge whether or not it affects their mental and/or motor performance adversely. Patients should be advised that if increased somnolence or episodes of falling asleep during activities of daily living (e.g., watching television, passenger in a car, etc.) are experienced at any time during treatment, they should not drive or participate in potentially dangerous activities until they have contacted their physician. 

 

Because of possible additive effects, caution should be advised when patients are taking other sedating medications or alcohol in combination with REQUIP and when taking concomitant medications that increase plasma levels of REQUIP(e.g., ciprofloxacin).

 

Because of the possible additive sedative effects, caution should also be used when patients are taking alcohol or other CNS depressants (e.g., antidepressants, benzodiazepines, ntipsychotics, etc.) in combination with REQUIP.  Patients should be informed they may experience hallucinations (unreal visions, sounds, or sensations) while taking REQUIP. These were uncommon in patients taking REQUIP for Restless Legs Syndrome. The risk is greater in patients with Parkinson’s disease; the elderly are at greater risk than younger patients with Parkinson’s disease; and the risk is greater in patients who are taking REQUIP with L-dopa, or taking higher doses of REQUIP.

 

Patients should be informed that some patients taking REQUIP have shown urges to behave in a way unusual for them. Examples of this are an unusual urge to gamble or increased sexual urges and/or behaviors. If patients or their family notice that they are developing any unusual behaviors, they should talk to their doctor.

 

Because of the possibility that REQUIP may be excreted in breast milk, patients should be advised to notify their physicians if they intend to breastfeed or are breastfeeding an infant.

 

Because REQUIP has been shown to have adverse effects on embryo-fetal development, including teratogenic effects (capable of causing birth defects), in animals, and because experience in humans is limited, patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy.

 

ADDITIONAL INFORMATION ON SIDE EFFECTS

 

General: Dyskinesia (movement-related side-effects):

REQUIP may worsen the impairment in the ability to control movements in patients treated with L-dopa for Parkinson’s disease.

 

Melanoma (Most Serious type of Skin Cancer):

Some studies showed Retroperitoneal Fibrosis (fibrous tissue growing outside or behind the abdominal wall) in patients with Parkinson’s disease.  They have a higher risk (perhaps 2- to 4 times higher) of developing melanoma than the general population. Patients using REQUIP for any reason should be made aware of these results and should undergo periodic dermatologic screening.

 

Events Reported in Parkinson’s Patients Being Treated with Dopamine Replacement Therapy: Withdrawal Emerges

 

Hyperpyrexia and Confusion:

Although not reported with REQUIP, a symptom resembling the Neuroleptic Malignant Syndrome (a response to neurological drugs) characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability.

 

Fibrotic Complications (fibrous tissue growing in or around organs and tissue):

Cases of, pulmonary (heart) infiltrates, pleural effusion (excess fluid between the two membranes that envelop the lungs), pleural thickening (thickening of the two membranes that envelop the lungs), pericarditis (inflamed sac around the heart), and cardiac valvulopathy (leading to heart damage dealing with the heart valves) have been reported in some patients treated with ergot-derived Dopamine agents. While these complications may resolve when the drug is discontinued, complete resolution does not always occur. A small number of reports have been received of possible fibrotic (fibrous tissue growing outside or around organs and tissue) complications, including pleural effusion, pleural fibrosis, lung disease, and cardiac valvulopathy (heart valve damage), during the development of the drug and once on the market.

 

Augmentation (the amount in which symptoms increase) and Rebound (increasing symptoms) in RLS:

Reports in the literature indicate treatment of RLS with Dopamine medications can result in a worsening of symptoms in the early morning hours, referred to as rebound. Augmentation has also been described during therapy for RLS. Augmentation refers to the earlier onset of symptoms in the evening (or even the afternoon), increase in symptoms, and spread of symptoms to involve other extremities. The frequency of augmentation and/or rebound after longer use of REQUIP and the appropriate management of these events, have not been evaluated in controlled clinical trials.

 

Impulse Control Symptoms Including Compulsive Behaviors:

Impulse control symptoms, including compulsive behaviors such as pathological gambling and hypersexuality, have been reported in patients treated with dopaminergic agents (Dopamine medications), including Ropinirole. As described in the literature, such behaviors have been reported principally in Parkinson’s disease patients treated with dopaminergic agents, especially at higher doses, and were generally reversible upon dose reduction or treatment discontinuation. In some cases with ropinirole, other factors were present such as a history of compulsive behaviors or concurrent dopaminergic treatment.

 

Renal Impairment:

The use of REQUIP in patients with severe renal impairment has not been studied.

 

Hepatic Impairment:

The effects of REQUIP have not been studied in patients with hepatic impairment. Since patients with hepatic impairment may have higher plasma levels and lower clearance, the dosage of REQUIP should be estimated with caution in these patients.

 

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3 Responses to “Restless Leg Syndrome and Requip, the Antipsychotic Drug and its Side Effects”

  1. Beth C. Says:

    Thank you so much for publishing this article! I had no idea why I was feeling hypersexual lately. Also, the nausea and vomiting were getting really bothersome. It got so bad that I wasn’t able to eat for two days, and being a dialysis patient, I need all the protein I can get! I hate RLS (which in me sometimes does spread to my arms), but I hate the side effects of REQUIP worse.

  2. FlielpClall Says:

    I think you made some good points in your post.

  3. tableau design Says:

    hi, that’s a city collection. There is few mistakes but the principal is here.


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