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Treatment of Restless Legs Syndrome

M. Krishna Menon, PhD; Arthur S. Kling, MD
Arch Neurol. 1983;40(8):526-526. doi:10.1001/archneur.1983.04210070066020
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To the Editor.  —We read with interest Akpinar's recent report (Archives 1982;39:739) on the beneficial effect of a levodopa-benserazide combination in relieving restless legs syndrome. That this drug regimen has not produced insomnia in their patients is noteworthy. Large doses of levodopa are known to increase waking time1 and to decrease rapid eye movement sleep2 in normal subjects. Because restless legs syndrome appears only at rest, and mostly before bedtime, a treatment that facilitates sleep may be more appropriate for this condition.It has been reported that certain benzodiazepines, especially clonazepam, relieve restless legs syndrome dramatically.3,4 In our animal model for myoclonus, in which the myclonic jerks are localized in the hind quarter (and hence resemble restless legs syndrome more closely than does myoclonus), clonazepam and flunitrazepam were 33 and 116 times more effective than diazepam, respectively, in blocking these jerks.5 This finding warrants the clinical

REFERENCES

Hartman E:  Effects of psychotropic drugs on sleep: The catecholamines and sleep , in Lipton MA, DiMascio A, Killam KF (eds): Psychopharmacology: A Generation of Progress . New York, Raven Press, 1978;, pp 711-728.
Kupfer DJ, Wyatt RJ, Scott J, et al:  REM inhibitory effect of l-dopa infusion during human sleep . Electroencephalogr Clin Neurophysiol 1973;;35:181-186.
Matthews WB:  Treatment of the restless legs syndrome with clonazepam . Br Med J 1979;;1:751.
Boghen D:  Successful treatment of restless legs with clonazepam . Ann Neurol 1981;;8:341.
Menon MK, Vivonia CA, Haddox VG:  A new method for the evaluation of benzodiazepines based on their ability to block muscimol-induced myoclonic jerks in mice . Psychopharmacology 1981;;75:291-293.
Bonetti EP, Pieri L, Cumin R, et al:  Benzodiazepine antagonist Ro 15-1788: Neurological and behavioral effects . Psychopharmacology 1982;; 78:8-18.
Goldberg MA, Dorman JD:  Intention myoclonus: Successful treatment with clonazepam . Neurology 1976;;26:24-26.
Van Woert MH, Sethy VH:  Therapy of intention myoclonus with l-5-hydroxytryptophan and a peripheral decarboxylase inhibitor, MK 486 . Neurology 1975;;25:135-140.

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Hartman E:  Effects of psychotropic drugs on sleep: The catecholamines and sleep , in Lipton MA, DiMascio A, Killam KF (eds): Psychopharmacology: A Generation of Progress . New York, Raven Press, 1978;, pp 711-728.
Kupfer DJ, Wyatt RJ, Scott J, et al:  REM inhibitory effect of l-dopa infusion during human sleep . Electroencephalogr Clin Neurophysiol 1973;;35:181-186.
Matthews WB:  Treatment of the restless legs syndrome with clonazepam . Br Med J 1979;;1:751.
Boghen D:  Successful treatment of restless legs with clonazepam . Ann Neurol 1981;;8:341.
Menon MK, Vivonia CA, Haddox VG:  A new method for the evaluation of benzodiazepines based on their ability to block muscimol-induced myoclonic jerks in mice . Psychopharmacology 1981;;75:291-293.
Bonetti EP, Pieri L, Cumin R, et al:  Benzodiazepine antagonist Ro 15-1788: Neurological and behavioral effects . Psychopharmacology 1982;; 78:8-18.
Goldberg MA, Dorman JD:  Intention myoclonus: Successful treatment with clonazepam . Neurology 1976;;26:24-26.
Van Woert MH, Sethy VH:  Therapy of intention myoclonus with l-5-hydroxytryptophan and a peripheral decarboxylase inhibitor, MK 486 . Neurology 1975;;25:135-140.

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