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Why dopaminergic for RLS but not for akathisia?

Posted by MB on June 26, 2003, at 10:50:57

I've had Restless Leg Syndrome my whole life. I've always been a foot wiggler. The etiology of this is supposed to involve some kind of dysfunction of the dopamine system, I'm told. I think my dopamine system has always been out of whack because I also had really bad tics growing up (eyelid, esophagus and diaphragm tics plus echolalia). Sometimes I wonder if it's because my mom took so much ephedrine while she was pregnant. Well, I'm getting off task, and blaming isn't appropriate...she loved me, and the possible hypoxia from her asthma (had she not taken the ephedrine) could have been even worse for me than the ephedrine, so who am I to judge why things are they way they are.

Anyway...back on task: when I take an antihistamine, withdrawal from caffeine or take an SSRI, I get symptoms that feel EXACTLY like Restless Leg Syndrome but much worse (in my whole body...sometimes I think of topping myself to be rid of the feeling). Since Mirapex is a wonder drug for Restless Leg Syndrome, I was prescribed this to take with my Lexapro. It paradoxically made the drug-exacerbated RLS (akathisia?) worse. It was unbearable.

My question is why would Mirapex be a wonder drug for Restless Leg Syndrom, but not work for akathisia. I've actually read that dopaminergics (levadopa and pergolide, according to this article) are worthless for akathisia: http://www.homestead.com/emguidemaps/files/akathisia.html#akathisia

However, the article also states that unlike Restless Leg Syndrome, with akathisia there is no dysesthesia (pain or uncomfortable sensation). Well, let me tell you that this drug induced restlessness is UNCOMFORTABLE (yes, I'm yelling). Without clonazepam, I'd either quit the med or shove a trocar through my aorta. So, if it's so uncomfortable, does that mean it's *not* akathisia? And if it's *not* akathisia (and, therefore, merely exacerbated RLS), then why did the Mirapex make it so unbearably worse?

What's the consensus here? Is akathisia just a drug induced Restless Leg Syndrome, or do they have two totally different causes (e.g. dopamine deficiencies in different areas)?

MB


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poster:MB thread:237227
URL: http://www.dr-bob.org/babble/20030624/msgs/237227.html