Zhao Mangsuo, Geng Tongchao, Qiao Liyan, Zhang Mingjie, Shi Jie, Huang Fangjie, Lin Xianzhong, Wang Jing, Zuo Huancong
Department of Neurology, Yuquan Hospital, Medical Center, Tsinghua University, Beijing, PR China.
School of Medicine, Nankai University, Tianjin, PR China.
J Clin Neurosci. 2014 Sep;21(9):1622-5. doi: 10.1016/j.jocn.2014.01.007. Epub 2014 May 27.
Only nine patients with olanzapine-induced restless legs syndrome (RLS) have been reported in the literature to our knowledge. We describe two patients with olanzapine-induced RLS treated at our hospital and review the nine reported patients. There were five women and six men aged between 28 and 62 years in the overall group. RLS symptoms emerged at olanzapine doses between 2.5 and 20mg. The symptoms improved in all patients when the dose was reduced and immediately disappeared when the medication was stopped. International Restless Legs Scale (IRLS) scores ranged from 10 to 35. Three patients had a family history of idiopathic RLS. Supplemental drugs were administered to control RLS symptoms in five patients. Ropinirole was effective in one patient, while two patients did not respond to the drug. Propoxyphene effectively relieved symptoms in one patient who did not respond to ropinirole or clonazepam. RLS symptoms did not recur following substitution of other antipsychotic drugs for olanzapine. In conclusion, olanzapine can induce RLS, particularly in patients with a family history of idiopathic RLS. More than half of the patients experienced severe to very severe symptoms. A dose-dependent relationship was observed between olanzapine and RLS symptoms. A gradual increase in dose may prevent olanzapine-induced RLS. The optimal treatment for olanzapine-induced RLS is discontinuation of olanzapine.
据我们所知，文献中仅报道了9例奥氮平所致的不宁腿综合征（RLS）患者。我们描述了在我院接受治疗的2例奥氮平所致RLS患者，并对报道的9例患者进行了回顾。总共有5名女性和6名男性，年龄在28至62岁之间。RLS症状出现在奥氮平剂量为2.5至20mg之间时。当剂量减少时，所有患者的症状均有所改善，停药后症状立即消失。国际不宁腿量表（IRLS）评分在10至35分之间。3例患者有特发性RLS家族史。5例患者使用了补充药物来控制RLS症状。罗匹尼罗对1例患者有效，而2例患者对该药物无反应。丙氧芬有效地缓解了1例对罗匹尼罗或氯硝西泮无反应患者的症状。用其他抗精神病药物替代奥氮平后，RLS症状未复发。总之，奥氮平可诱发RLS，尤其是有特发性RLS家族史的患者。超过一半的患者经历了严重至极严重的症状。奥氮平和RLS症状之间存在剂量依赖关系。逐渐增加剂量可能预防奥氮平所致的RLS。奥氮平所致RLS的最佳治疗方法是停用奥氮平。
