Department of Psychiatry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Department of Psychiatry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Sleep Med. 2018 May;45:39-43. doi: 10.1016/j.sleep.2017.09.028. Epub 2017 Nov 22.
Many patients with opioid use disorder report symptoms similar to restless legs syndrome (RLS) during withdrawal. However, whether these symptoms are true RLS, their predictors and effect of treatment with pregabalin are still unknown.
A total of 19 consecutive patients with opioid use disorder who were admitted for detoxification were included in this study after obtaining informed consent. Information regarding addiction was noted, and they were screened for RLS every morning and evening. Patients were also asked to provide information regarding their sleep quality during the previous night. To control opioid withdrawal, they were prescribed buprenorphine. Pregabalin was prescribed to patients who developed RLS. For analysis, patients were divided in two groups: those with RLS and those without RLS.
The average age of the subjects included in this study was 30.2 (±10.4) years. Mean duration of substance abuse was 56.8 (±38.4) months. Ten patients developed symptoms of RLS. Groups with RLS and without RLS were comparable with reference to demographics, laboratory parameters, and dose of buprenorphine that was required to control withdrawal symptoms. On average, RLS appeared after 1.7 days of abstinence. Patients described their symptoms such as crawling, creeping sensation in the muscles or "just pain". Eight out of 10 subjects reported symptoms limited to legs; however, two described similar problems in their upper limbs as well. A change in sleep pattern was observed with delayed sleep onset at night, delayed wake time in the morning, and spending a major proportion of day asleep. Pregabalin brought significant relief to the symptoms of RLS and sleep quality.
RLS during opioid withdrawal was an independent illness seen in half of the patients. It appeared to be mediated through mu-receptors, with contributions from other factors. Pregabalin improved symptoms of RLS and quality of sleep in these patients.
许多阿片类药物使用障碍患者在戒断期间报告有类似于不宁腿综合征（RLS）的症状。然而，这些症状是否为真正的 RLS、其预测因素以及普瑞巴林治疗的效果仍不清楚。
本研究共纳入 19 例连续因阿片类药物使用障碍而入院戒毒的患者，在获得知情同意后纳入研究。记录成瘾相关信息，并于每天早晚筛查 RLS。还询问患者前一晚的睡眠质量信息。为控制阿片类戒断，为患者开具丁丙诺啡。对出现 RLS 的患者开具普瑞巴林。为分析，将患者分为两组：有 RLS 组和无 RLS 组。
本研究纳入患者的平均年龄为 30.2（±10.4）岁。滥用物质的平均时间为 56.8（±38.4）个月。10 例患者出现 RLS 症状。有 RLS 和无 RLS 两组在人口统计学、实验室参数以及控制戒断症状所需丁丙诺啡剂量方面具有可比性。平均而言，RLS 在戒断后 1.7 天出现。患者描述其症状为肌肉蠕动、爬行感或“只是疼痛”。10 例患者中有 8 例报告腿部症状局限于腿部；然而，也有 2 例报告上肢也有类似问题。观察到睡眠模式发生变化，夜间入睡时间延迟，早晨醒来时间延迟，白天大部分时间都在睡觉。普瑞巴林显著缓解了 RLS 症状和睡眠质量。
阿片类药物戒断期间的 RLS 是一半患者中独立存在的疾病。它似乎是通过μ受体介导的，其他因素也有贡献。普瑞巴林改善了这些患者的 RLS 症状和睡眠质量。
