Withania somnifera as an Adjunctive Treatment for Refractory Restless Legs Syndrome in Parkinson’s Disease: A Case Report

Abstract

Non-motor symptoms of Parkinson's disease (PD), such as insomnia and restless legs syndrome (RLS), tend to worsen and become refractory as neurodegeneration progresses. We report the case of a 72-year-old female with a six-year history of PD and two-and-half-year history of insomnia and refractory RLS. We added a neuroprotective agent, Withania somnifera, to the existing treatment regimen for her insomnia. Besides the partial remission of her insomnia and motor symptoms of PD, there was a complete reversal of the RLS symptoms. Withania somnifera has been shown to improve PD symptoms by preventing oxidative damage of the nigrostriatal dopaminergic neurons and improving dopamine levels in the midbrain and corpus striatum. Our case provides the first-time evidence where Withania somnifera added for insomnia caused a complete remission of refractory RLS, possibly due to its anti-apoptotic and pro-dopaminergic actions. Withania somnifera could prove beneficial in cases where the disease advances but further addition of dopamine agonists for refractory RLS is not possible due to the risk of dopamine augmentation.

Ashwagandha (Withania somnifera) - influence on sleep: review

“…Chaudhari KS et al ( 2021) opisuje przypadek 72-letniej kobiety cierpiącej z powodu choroby Parkinsona poddanej 2-miesięcznej suplementacji ashwagandą w celu terapii bezsenności. Oprócz częściowego ustąpienia zaburzeń snu, nieznacznego zmniejszenia się drżenia mięśniowego oraz sztywności, u pacjentki zaobserwowano całkowite ustąpienie objawów zespołu niespokojnych nóg [8].…”

Withania somnifera influences MDMA-induced hyperthermic, cognitive, neurotoxic and neuroinflammatory effects in mice

“…Potential neuroprotective effects of various active constituents of WS have been studied in toxin-induced animal models of PD [4,17], together with their effects on mitochondrial dysfunctions [5,18], neuroinflammation [17], and motor impairment [6,17,18]. Moreover, studies in PD patients have revealed that WS administration caused a complete remission of treatment-refractory restless leg syndrome [19]. The mechanisms proposed for the observed therapeutic effects of WS in experimental models of PD and parkinsonian patients, similarly to those proposed for studies of AD, involve an enhanced bioavailability of antioxidant agents (i.e.…”