Growth hormone response to low-dose apomorphine in restless legs syndrome

Continuous Subcutaneous Apomorphine Infusion Improves Severe Restless Legs Syndrome

“…We cannot rule out a certain placebo or reward effect, because pain remained on the same level during saline infusion. Previous reports describe distinct lower therapeutic dosages of apomorphine applied over shorter intervals in RLS patients . In conclusion, SC high‐dosage apomorphine infusion may be a therapeutic option for severe symptomatic RLS cases.…”

“…Previous reports describe distinct lower therapeutic dosages of apomorphine applied over shorter intervals in RLS patients. [1][2][3][4][5] In conclusion, SC high-dosage apomorphine infusion may be a therapeutic option for severe symptomatic RLS cases.…”

New tricks for an old dog: A repurposing approach of apomorphine

“…RLS is a common sensorimotor disorder associated with brain iron deficiency, neurotransmission abnormalities in the dopaminergic (D 2 -receptors) and opiate systems, and abnormal activity in a distributed cortical and subcortical network (Mano & Thomas, 2018). The fact that the apomorphine challenge (0.005 mg/kg of body weight) does not induce a GH increase in RLS patients (contrary to PD) support the hypothesis that RLS is not solely a dopaminergic disorder (Happe et al, 2007). Either primary (familial) or secondary (druginduced, uraemia, iron deficiency), RLS appears to be more prevalent in neurodegenerative diseases such as PD and multiple system atrophy (MSA) (Reuter et al, 1999;Tribl et al, 2005;Tings et al, 2005;Ghorayeb et al, 2014).…”

“…Either primary (familial) or secondary (druginduced, uraemia, iron deficiency), RLS appears to be more prevalent in neurodegenerative diseases such as PD and multiple system atrophy (MSA) (Reuter et al, 1999;Tribl et al, 2005;Tings et al, 2005;Ghorayeb et al, 2014). Leg paresthesias and/or dysesthesias, occurring at rest, causing an urge to move, are characteristics, and usually relieved by movement (Happe et al, 2007;Mano & Thomas, 2018). Symptoms often worsen at night and negatively affect sleep and quality of life (Happe et al, 2007).…”

An update on the pathophysiology and genetics of restless legs syndrome

“…The availability of dopamine in several brain circuits exhibits a circadian nadir that coincides with the late evening peak in RLS symptoms [ 7 , 23 ]. Hypothalamic-pituitary axis circuits under dopaminergic control in RLS patients respond in an exaggerated fashion to nocturnal administration of dopaminomimetics (manifest as increased suppression of prolactin and increased release of growth hormone) [ 24 ] but not to morning administration [ 25 ]. Similarly, dopamine metabolites in the cerebrospinal fl uid are no different in RLS patients than in controls when measured in the morning, but RLS patients appear to exhibit exaggerated extremes in diurnal fl uctuations of dopamine and its metabolites when compared with controls [ 26 ].…”