Sieb Jörn P
Klinik für Neurologie, Geriatrie und Palliativmedizin, Hanse-Klinikum Stralsund.
Med Monatsschr Pharm. 2010 Apr;33(4):133-9.
In Germany approximately one percent of the population suffers from clinically relevant restless legs syndrome (RLS). Three non-ergoline dopamine agonists and levodopa/benserazide are now specifically licensed for RLS in Germany. Augmentation is the main complication of long-term dopaminergic treatment of RLS. Augmentation is defined as a paradoxical worsening of the symptoms during long-term dopaminergic treatment with increasing dose. According to a recent study this occurs in up to 60% of RLS patients during the first 6 months of treatment. Augmentation emerges less frequently during dopamine agonist treatment. The dopamine agonist doses required for the treatment of RLS patients is far below the dose range in Parkinson therapy. However, severe complications of dopamine agonist treatment can occur even in this dose range, like compulsive behaviours. A considerable number of RLS patients needs non-dopaminergic treatment for RLS. Most of them receive opioids as one of the second-line options in RLS therapy.
在德国，约1%的人口患有具有临床相关性的不宁腿综合征（RLS）。目前，三种非麦角类多巴胺激动剂以及左旋多巴/苄丝肼在德国已被专门批准用于治疗RLS。症状加重是RLS长期多巴胺能治疗的主要并发症。症状加重被定义为在长期多巴胺能治疗期间，随着剂量增加症状反而出现反常恶化。根据最近一项研究，在治疗的前6个月内，高达60%的RLS患者会出现这种情况。在多巴胺激动剂治疗期间，症状加重出现的频率较低。治疗RLS患者所需的多巴胺激动剂剂量远低于帕金森病治疗中的剂量范围。然而，即使在这个剂量范围内，多巴胺激动剂治疗也可能出现严重并发症，如强迫行为。相当一部分RLS患者需要接受非多巴胺能药物治疗RLS。他们中的大多数人将阿片类药物作为RLS治疗的二线选择之一。
