Ghosh Abhishek, Basu Debasish
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Drug De-addiction & Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Psychol Med. 2014 Jan;36(1):85-7. doi: 10.4103/0253-7176.127262.
Although frequently underdiagnosed, several epidemiological studies have estimated the prevalence of restless legs syndrome (RLS) in western countries at 5-15% of the general population. The diagnosis is usually made on a clinical basis, according to the criteria established by the international RLS study group. There are case reports of transient RLS in opiate withdrawal. We describe three opiate (dextropropoxyphene (DPP)) dependent young male patients; two of them had DPP intoxication/withdrawal seizure developing RLS during opiate withdrawal. However, their RLS persisted even after the remission of other withdrawal symptoms. Thyroid function test, hemogram, serum ferritin were normal in all of them. The cases responded well to a treatment with ropinirole. Hence, there might be a causal association, which required further well-designed studies to substantiate. The sleep disturbances and use of benzodiazepines can be minimized by increasing clinician's sensitivity to diagnose RLS.
尽管不宁腿综合征(RLS)常常未得到充分诊断,但多项流行病学研究估计,西方国家普通人群中RLS的患病率为5%至15%。诊断通常依据国际RLS研究小组制定的标准,基于临床情况做出。有关于阿片类药物戒断时出现短暂性RLS的病例报告。我们描述了三名对阿片类药物(右丙氧芬(DPP))成瘾的年轻男性患者;其中两名患者在阿片类药物戒断期间出现DPP中毒/戒断性癫痫发作,并发展为RLS。然而,即使其他戒断症状缓解后,他们的RLS仍持续存在。他们所有人的甲状腺功能检查、血常规、血清铁蛋白均正常。这些病例对罗匹尼罗治疗反应良好。因此,可能存在因果关联,这需要进一步设计完善的研究来证实。通过提高临床医生对RLS诊断的敏感性,可将睡眠障碍和苯二氮䓬类药物的使用降至最低。