Perroud Nader, Lazignac Coralie, Baleydier Bertrand, Cicotti Andrei, Maris Susanne, Damsa Cristian
Service d'accueil, d'urgence et de liaison psychiatrique, Universitary Hospital Geneva, 1211 Geneva, Switzerland.
Gen Hosp Psychiatry. 2007 Jan-Feb;29(1):72-4. doi: 10.1016/j.genhosppsych.2006.10.006.
The objective of this case report is to create awareness on restless legs syndrome (RLS) among clinicians working in emergency units.
We describe a case reporting important aggravation of RLS associated with citalopram, 60 mg/day, in a 48-year-old woman who was sent to the emergency unit by her general practitioner. Citalopram was replaced by bupropion, 150 mg/day, and sertraline, 50 mg/day.
Three days later, symptoms of RLS started to diminish and, after 3 weeks, clinical symptoms had disappeared entirely. On 6-month follow-up, the patient did not manifest clinically significant RLS. Ignoring RLS could lead to a worsening of symptoms and could increase the risk for iatrogenic conditions. The prevalence of RLS in the general population is 3-9%; nevertheless, this syndrome is frequently underdiagnosed.
This case report suggests that RLS could be considered as a possible "dopamine-dependent side effect" of selective serotonin reuptake inhibitors (SSRIs). Bupropion could potentially "correct" dopaminergic dysfunction in RLS, and sertraline appears to be the SSRI that provides the least risk of RLS by blocking dopamine reuptake.
本病例报告的目的是提高急诊科临床医生对不宁腿综合征（RLS）的认识。
我们描述了一例病例，一名48岁女性由全科医生送至急诊科，其RLS因每天服用60毫克西酞普兰而显著加重。将西酞普兰换为每天150毫克安非他酮和每天50毫克舍曲林。
三天后，RLS症状开始减轻，3周后临床症状完全消失。在6个月的随访中，患者未出现具有临床意义的RLS。忽视RLS可能导致症状恶化，并可能增加医源性疾病的风险。普通人群中RLS的患病率为3%-9%；然而，该综合征经常被漏诊。
本病例报告表明，RLS可被视为选择性5-羟色胺再摄取抑制剂（SSRI）可能的“多巴胺依赖副作用”。安非他酮可能潜在地“纠正”RLS中的多巴胺能功能障碍，而舍曲林似乎是通过阻断多巴胺再摄取而导致RLS风险最低的SSRI。
