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RESTLESS LEG SYNDROME (RLS)

RESTLESS LEG SYNDROME
David Neubauer, M.D. Wed, Jun 20, 2007

The medical community's recognition of restless legs syndrome (RLS) has evolved over the past few decades. For years, patients complained to their doctors that they experienced a very uncomfortable and distressing feeling in their legs in the evening when they tried to rest, and eventually their doctors considered RLS to be a disorder.

RLS often interferes with the ability to fall asleep easily. Usually, patients do not describe it as painful, but more like a "creepy-crawly" sensation that creates a strong and irresistible urge to move the legs. Moving does help, but only for brief moments. Once people suffering with RLS fall asleep, they tend to have involuntary leg kicks.

The cause of RLS is not completely understood; however, it is thought to be associated with the function of dopamine, a nervous system neurotransmitter. Long ago, it was recognized that people with anemia were more likely to develop RLS, which makes sense because iron plays a role in how dopamine operates in the brain.

When patients come in with RLS, we check their blood levels of iron and ferritin, which represent the body's capacity to store iron.

Pregnancy also may cause RLS, but usually the symptoms improve after the baby is delivered. However, some women who have had several children eventually have persistent RLS. Patients with some kidney diseases are more likely to develop RLS, and it can be caused by the use of some medications, especially antidepressants and antipsychotics. It does tend to run in families.

A variety of medications have been prescribed to try to help RLS patients. For many years, sleep specialists have prescribed medications that enhance dopamine functioning in the brain. These dopamine agonists already were available for the treatment of Parkinson disease, which, for very different reasons, is also associated with abnormalities in brain dopamine activity.

Some of the pharmaceutical companies that made these medications did the required research studies to gain official FDA approval for the treatment of RLS. Now there is more awareness among the public and medical professionals about RLS, due to medication advertising and other media attention.

A common question about RLS is whether it is really an actual condition. Certain comedians recently have made fun of the disorder's name and have suggested that it is simply made up. Some people skeptical of the pharmaceutical industry believe that RLS was defined as a disorder just to sell pills. Obviously, none of them suffer with RLS or have family members with the disorder. Researchers are making steady progress in understanding the underlying causes of RLS.

Health care professionals should check to see whether their patients have RLS. One question is enough to see whether they might have it. A "no" answer rules it out. A "yes" answer should lead to further evaluation. Here's the question: "When you try to relax in the evening, or go to sleep at night, do you ever have unpleasant, restless feelings that can be relieved by walking or movement?"

There’s really no question about it — RLS is a serious problem for many people. Those with mild symptoms might not need any medication for their symptoms. Fortunately, treatments are available for people with more severe symptoms. If the approved dopamine agonists don’t help or cause bothersome side effects, there are several other medications that might be helpful.

SOURCE: http://www.freewebs.com/medcanaware/neurol...aldisorders.htm 

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Dr. Phil Leveque Salem-News.com
Aug-18-2007 20:26

Phillip Leveque has spent his life as a Combat Infantryman, Physician and Toxicologist.
Restless leg syndrome
Image courtesy: sleepdisordersfyi.com

(MOLALLA, Ore.) - There may be 10 million RLS patients in the U.S. This will be good news to them. I was one of the first doctors to sign up patients for Oregon’s medical marijuana permits. I had patients number 13 and 14.

Through the five years I was able to work before the Oregon Board of Medical Examiners revoked my license, I had between 4 and 6 thousand patients. I never did count them because I saw patients in at least twenty places from the coast to Bend and Klamath Falls in Eastern Oregon.

Why I had to travel all over the state is not a mystery. Other doctors were afraid of their own shadows and big brother to do this. However, eventually 2,200 doctors did shake off their paranoia and finally joined the club. Hoorah.

The original medical marijuana bill in California in 1998 required the following disease entities to get a “permit”: cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, and arthritis.

This was a rather loose list but it did give the doctor the option of recommending it for “any other illness for which marijuana provides relief.” This gave California doctors wide latitude for issuing permits.

Dr. Tod Mikiyuria found after interviewing and/or reviewing about 30,000 patient charts that marijuana was effective for about 200 separate medical entities.

It is difficult for most physicians to believe it could be effective for such a wide variety of conditions, and I as a Professor of Pharmacology took in all this with a grain of salt till I started seeing affected patients. It was one surprise after another. I got over the idea that the patients might be faking it to get a permit because it cost about $150 dollars to go through my clinics and the state charged $100 dollars for the permit. Would the patients fake it if it still cost $250 dollars? I doubt it.

When the first patient came in with “restless leg syndrome” I was bemused for a while. What’s going on here, I said to myself.

I knew that quadriplegics, paraplegics, multiple sclerosis and cerebral palsy patients had legs that jumped around and marijuana gave them relief. All these seemed to be treated poorly with valium-like drugs and the doses were high enough to be strongly sedative and extremely addicting. It didn’t take many doctor “smarts” to figure out if the restless leg patient said marijuana works, it must be so.

According to T.V. news programs, about 10 million patients have restless legs. Marijuana is a nice, safe, effective medicine. The big problem is that only in eleven states can the patients get a permit to use marijuana legally.

DO YOU HAVE A QUESTION FOR DR. LEVEQUE? Email: newsroom@salem-news.com

source: http://www.salem-news.com/articles/august1...tless_81807.php 

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Disease Mongering for Restless Leg Syndrome
by Jeffrey Dach MD

A textbook example of disease mongering by the pharmaceutical industry is the case of Requip for Restless Leg Syndrome.

What is Requip and Mirapex?

Requip is a powerful drug for Parkinson’s Disease. Requip is also used to treat movement disorders caused by anti-psychotic drugs for mental patients (such as Prolixin and Haldol). Mirapex is similar to Requip.

Magnesiun Deficiency Causes Restless Legs

Magnesiun deficiency causes muscle cramps at night and is the most common cause of Restless Leg Syndrome. (2) Sixty Eight Per Cent (68%) of Americans are Magnesium deficient, according to the USDA Agricultural Research Service.(3) Restless Leg Syndrome, or leg muscle cramping during sleep is not a reason for powerful Parkinson's drugs. Inexpensive magnesium supplementation usually resolves the problem. Using a drug like Requip instead of supplementing for magnesium deficiency is the height of lunacy, and would be comical if it wasn't tragic. This is typical drug mongering indicative of a broken medical system.

Magnesium Deficiency, Not Requip Deficiency

In a medical study by Hornyack, Restless Leg Syndrome (RLS) significantly improved after supplementing with magnesium (about 300 mg each evening for four to six weeks).(4) Another study by Popoviciu showed that magnesium deficiency causes neuromuscular excitability and impaired sleep.(5) Another study by Bartel showed IV Magnesium to be curative for Restless Leg Syndrome when IV magnesium was incidentally given to pregnant women as a treatment for eclampsia.(6) Magnesium supplementation is especially important for diabetic patients with insulin resistance.(7)
There are many more studies in the medical literature showing the connection between magnesium deficiency and restless legs at night, muscle cramps and muscle pain. We have found in our experience that oral magnesium supplementation works quite well, resolving the problem promptly in most cases.

More on Disease Mongering? http://jeffreydach.com/2008/04/02/restless...ey-dach-md.aspx 

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Alternative Treatment for Restless Leg Syndrome; Cannabis

Today in my Irvine office I had a follow up appointment with a 54 year old male who suffers from Restless Leg Syndrome. He had been using a medication called Requip (ropinirole) for the past 6 months without good results. His doctor recently switched him to a new medication called Mirapex (pramipexole) which has not been effective either. Both of those drugs work by stimulating dopamine receptors in the brain (dopamine is a neurotransmitter). They are drugs similar to those used to treat patients with parkinsons disease.

The patient started medicating with cannabis a year ago when I first evaluated him because his restless legs were making it very difficult to fall asleep. As a result he was experiencing daytime fatigue and it was really starting to affect his quality of life. His mood suffered because he did not feel rested. This spiraled into frequent arguments with his wife. It truly was a major problem for him.

Secondly, the Mirapex commonly causes nausea, fatigue and lightheadedness. This patient was experiencing from routine nausea as a result of his medication.

Cannabis was essential in his treatment plan. It allowed him to fall asleep much faster than normal and also eliminated any nausea he experienced from taking his medication. ”It has saved my life this past year” he said referring to his cannabis use. His dosing schedule was to inhale using a vaporizer two doses of an indica strain called presidential kush. He said that within 30 minutes he would fall asleep and wake up feeling rested. His mood improved as did his relationship with his wife.

Cases like these are perfect examples of how cannabis can improve the quality of patients lives. it is truly a benign drug when compared to other pharmaceuticals that doctors prescribe. You can’t overdose on it and it does not effect your liver or kidneys like many other commonly prescribed medications.

source: http://mcsocal.com/b...juana-cannabis/