Efficacy of pergolide in treatment of restless legs syndrome

Trenkwalder, Claudia; Hundemer, Hans-Peter; Lledó, Alberto; Swieca, John; Polo, Olli; Wetter, Thomas C.; Ferini‐Strambi, Luigi; Groen, Henk; Quail, Deborah; Brandenburg, U.

doi:10.1212/01.wnl.0000124465.20878.84

Cited by 107 publications

(39 citation statements)

References 41 publications

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“…The improvement in RLS symptoms occurred as early as 6 weeks, similar to the time course of common pharmaceutical treatments, 12,22 and the reduction in RLS symptoms was maintained throughout the 3 month intervention period. Additionally, the improvement in RLS symptoms appeared to show a ceiling effect at 6 weeks, with no further significant improvement occurring.…”

Section: Discussionsupporting

confidence: 57%

“…Again, this may be similar to pharmacological treatment, as in trials of pharmaceuticals for RLS, the response to treatment appears to be greatest at 6 to 12 weeks, with further treatment not providing additional reduction in symptoms. 22,23 Future studies are needed to further address the effects of exercise on the symptoms of RLS. The current study results are promising, but larger studies are necessary before exercise is routinely prescribed for RLS.…”

Section: Discussionmentioning

confidence: 99%

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Exercise and Restless Legs Syndrome: A Randomized Controlled Trial

Aukerman¹,

Aukerman²,

Bayard³

et al. 2006

The Journal of the American Board of Family Medicine

228

112

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Background and Objectives: Restless legs syndrome (RLS) is a common, underdiagnosed neurological movement disorder of undetermined etiology. The primary treatments for restless legs syndrome are pharmacological. To date, no randomized controlled trials have examined the effectiveness of an exercise program on the symptoms of RLS.Methods: Study participants (N ‫؍‬ 41) were randomized to either exercise or control groups. 28 participants (average age 53.7; 39% males) were available and willing to begin the 12-week trial. The exercise group was prescribed a conditioning program of aerobic and lower-body resistance training 3 days per week. Restless legs symptoms were assessed by the International RLS Study Group (IRLSSG) severity scale and an ordinal scale of RLS severity at the beginning of the trial, and at 3, 6, 9, and 12 weeks.Results: Twenty-three participants completed the trial. At the end of the 12 weeks, the exercise group (N ‫؍‬ 11) had a significant improvement in symptoms compared with the control group (N ‫؍‬ 12) (P ‫؍‬ .001 for the IRLSSG severity scale and P < .001 for the ordinal scale). Conclusions Background and ObjectivesRestless Legs Syndrome (RLS) is a common neurological movement disorder affecting a large segment of the population. Studies of the prevalence of RLS suggest the condition affects approximately 10% of the adult population, although one study found a prevalence of 24% in patients presenting to a primary care office.1-3 Although RLS is common, it is seldom diagnosed. The 2001 Sleep in America Poll found a prevalence of 13% in the adult population, but only 3% of those had actually been diagnosed with RLS. 4 Factors associated with higher incidence of RLS include older age, multiparity, sedentary lifestyle, positive family history, and obesity.1,2 Secondary causes of RLS include iron deficiency, renal failure, neuropathy, pregnancy, and certain medications. 5 RLS is associated with depression, anxiety, and negative quality of life. 6,7 The diagnosis of RLS is clinical. Minimal criteria for the diagnosis are: 1) a compelling urge to move the limbs, usually associated with paresthesias/dysesthesias; 2) motor restlessness as seen in activities such as floor pacing, tossing and turning in bed, and rubbing the legs; 3) symptoms worse or exclusively present at rest (ie, lying, sitting) with variable and temporary relief by activity; and 4) symptoms worse in the evening and at night. 8 RLS tends to cluster in older, overweight adults, 6,9,10 who are at increased risk for comorbid conditions. Physical activity and exercise may be important in the reduction of the risk for comorbid conditions; however, the effects of exercise on RLS severity are unknown. Furthermore, the current treatment for RLS is primarily pharmacological in nature. The vast majority of clinical trials have concentrated on the use of dopaminergic agents, anticonvulsants, and benzodiazepines.11-13 These agents often have significant side effects. Little research has been undertaken to determine whether lifestyle changes, ...

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Exercise and Restless Legs Syndrome: A Randomized Controlled Trial

Aukerman¹,

Aukerman²,

Bayard³

et al. 2006

The Journal of the American Board of Family Medicine

228

112

View full text Add to dashboard Cite

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“…These findings were attenuated but remained robust in the ITT analysis (Table 3; P Ͻ 0.0001). In a sensitivity analysis restricted to the 25 participants from the per-protocol cohort with baseline moderate-to-severe RLS, SDHD resulted in an even larger 8-to 9-point decrease in the mean IRLS score at 4 and 12 months (23 (21,25) versus 14 (9,20) versus 13 (8,18); P Ͻ 0.001). The ITT analysis yielded similar results among the 57 participants with baseline moderate-to-severe RLS, with a significant 6-to 7-point improvement over the same time period (P Ͻ 0.001).…”

Section: Effect Of Sdhd On Rlsmentioning

confidence: 97%

“…Nine of the 10 items investigate two dimensions of RLS severity, symptoms (six items), and symptoms effect (three items). This self-administered instrument was developed and validated by the IRLS Study Group (18,20) and has been used to test the efficacy of drugs developed for treatment of RLS (21,22). Responses are graded from 0 to 4, with a higher score reflecting higher severity.…”

Section: Assessment Of Rls and Symptoms Severitymentioning

confidence: 99%

Impact of Short Daily Hemodialysis on Restless Legs Symptoms and Sleep Disturbances

Jaber

Schiller

Burkart

et al. 2011

Clinical Journal of the American Society of Nephrology

101

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SummaryBackground and objectives Restless legs syndrome (RLS) and sleep disturbances are common among in-center hemodialysis patients and are associated with increased morbidity/mortality. Design, setting, participants, & measurementsThe FREEDOM study is an ongoing prospective cohort study investigating the benefits of home short daily hemodialysis (SDHD) (6 times/week). In this interim report, we examine the long-term effect of SDHD on the prevalence and severity of RLS, as measured by the International Restless Legs Syndrome (IRLS) Study Group rating scale, and sleep disturbances, as measured by the Medical Outcomes Study sleep survey.Results 235 participants were included in this report (intention-to-treat cohort), of which 127 completed the 12-month follow-up (per-protocol cohort). Mean age was 52 years, 55% had an arteriovenous fistula, and 40% suffered from RLS. In the per-protocol analysis, among patients with RLS, the mean IRLS score improved significantly at month 12, after adjustment for use of RLS-related medications (18 versus 11). Among patients with moderate-to-severe RLS (IRLS score Ն15), there was an even greater improvement in the IRLS score (23 versus 13). The intention-to-treat analysis yielded similar results. Over 12 months, there was decline in the percentage of patients reporting RLS (35% versus 26%) and those reporting moderate-to-severe RLS (59% versus 43%). There was a similar and sustained 12-month improvement in several scales of the sleep survey, after adjustment for presence of RLS and use of anxiolytics and hypnotics.Conclusions Home SDHD is associated with long-term improvement in the prevalence and severity of RLS and sleep disturbances.

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“…A long-term study revealed no serious adverse effects of pergolide, over 48 weeks, at doses from 0.5 to 0.75 mg 62 . However, although effective in the treatment of RLS, pergolide was withdrawn from the U.S. market due to the risk of cardiac valvulopathy (derived from the experience over use of ergot in the treatment of Parkinson's disease and prolactinomas and endorsed by study recente 63 .…”

Section: Major Da Ergot Pergolidementioning

confidence: 96%