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Dr. Bob is Robert Hsiung, MD,
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Posted by Phillipa on June 12, 2009, at 21:24:37
Well if you wish to compulsively shop, gamble,etc, get RLS and take dopamine. Phillipa
SLEEP 2009: Dopaminergic Agents Linked to Impulse-Control Disorders in Restless-Legs Syndrome
Jim Kling
Dr. Daniel Mikol discusses the findings from the multicenter REGARD study.Click here. June 12, 2009 (Seattle, Washington) A new study shows that impulse-control disorders, particularly compulsive shopping and pathologic gambling, occur frequently with the use of dopaminergic agents in the treatment of restless-legs syndrome (RLS).Dopaminergic agents are used to treat Parkinson's disease (PD), and an increase in impulse-control disorders is a known adverse effect of treatment with these drugs in that setting. These agents are also now commonly prescribed for RLS.
The study showed that "impulse-control disorders are common with the use of dopaminergic agonists [in RLS patients], but discontinuing can often lead to a rapid resolution," Jason Cornelius, MD, a resident in neurology at the Mayo Clinic in Rochester, Minnesota, told attendees here.
The fact that the adverse effects were seen in unrelated conditions such as PD and RLS "supports the theory that it's the medicine rather than the underlying disease that is to blame," Dr. Cornelius added.
He presented the results here at SLEEP 2009: 23rd Annual Meeting of the Associated Professional Sleep Societies.
Survey Results
In this study, the researchers set out to determine the frequency of impulse-control disorders in RLS patients treated with dopaminergic agents. They sent a survey to 3 groups of subjects: 100 patients with RLS who had been treated or were currently being treated with dopaminergic agents; 275 obstructive sleep apnea (OSA) patients who did not have RLS and had not received dopaminergic agents (OSA controls); and 52 RLS patients who had never received dopaminergic drugs (RLS controls).
No patients with PD were included in the study. When respondents indicated the presence of impulse-control disorders on the screening questionnaire, the researchers conducted follow-up telephone interviews to confirm the diagnoses.
RLS patients treated with dopaminergic agents showed an increased incidence of impulse-control disorders compared with the other groups, specifically an increased frequency of compulsive shopping, pathologic gambling, hypersexuality, and punding, which is a fascination with performance of repetitive mechanical tasks such as building small wooden boxes.
The increased frequency was statistically significant for compulsive shopping (P = 0.0002), pathologic gambling (P = 0.006), and punding (P = 0.005) compared with OSA controls. Against RLS controls, they found a statistically significant increase in compulsive shopping (P =0.03) in the RLS patients on dopaminergic agents.
Impulse Control Disorders in RLS Patients Treated with Dopaminergic Agents vs Controls End Point RLS Patients Receiving Dopaminergic Agents (%) Obstructive Sleep Apnea Controls (%) RLS Patients Not Treated With Dopaminergic Agents (%)
Compulsive shopping 9 .07 0
Pathologic gambling 5 .04 2
Hypersexuality 3 .04 0
Punding 7 1 0
Eight patients with impulse-control disorders discontinued use of the dopaminergic agents; 7 of the disorders resolved within a few weeks; and the other 1 improved significantly."It doesn't mean you don't continue to use these drugs [to treat RLS] . . . but every patient must be warned [of impulse-control disorders and potential adverse effects] and questioned on return visits," Michael Silber, MBchB, professor of neurology at the Mayo Clinic College of Medicine and the study's lead researcher, told Medscape Neurology. "We've seen some devastating complications."
"It's an incredibly important study, but we need to give more specific guidelines to help physicians warn or alert patients they have to ask to see if [impulse-control disorders] are happening," Richard Allen, PhD, a research associate in neurology at Johns Hopkins Medicine, in Baltimore, Maryland, told Medscape Neurology.
Dr. Cornelius, Dr. Silber, and Dr. Allen have disclosed no relevant financial relationships.
Association of Professional Sleep Societies 2009 Annual Meeting: Abstract 0900. Presented June 10, 2009.
Posted by rjlockhart04-08 on June 12, 2009, at 23:03:05
In reply to Dopamine Meds, RLS, And Impulse Control, posted by Phillipa on June 12, 2009, at 21:24:37
Yes that's why, you have a stable, can't have implusive (trigger's mania, then you go into depression due to lack of nuerotransmitter, mainly dopamine.)
Yet the past, some mood stablizer's worse' the effect. Dopamine is drive, getting things done, and seeing pleaure or "good" feeling in what your do. When that's lacked, i've written articles, posts, and felt like "nothing". Yet then, look back, some are good and brilliant, other's are hidious. Not to mention myself at all.
Abilify....bye bye, couldnt take that, made me so lifeless, my gosh, what's phizer trying do take life away? Excuse me, that's haliperidol, that's the big mama! i would scream if saw that, "RIP" get away from it!Anyways, back to what i was saying, stimulants, with some/mood stabilzer, or even a tranquilizer (longacting one). Phenobarbital, Tranxene could level anxiety, with a stimulant. Yet it's been known in the past Dexamyl, to....be abused so...EEE that's out of the question. I don't know why they came up with idea in the first place.
So....the best, Dexedrine. Not Adderall, not Ritlin, either Vyvanse, those are not good. Dexedrine is a basic medication with no other' stuff to spice the market value of it up. Yet it was famous in the past. WWII.
To adequatly get a stable "dopamine" flow, obviously with/this case i deal with myself (me). It stimulates dopamine and other nueron's that cause activity in the frountal lobe, and central cortex. Also body - heart stimulation, sweating, can be (are) side effects. Just depends on that inviduel.
You can sit still and feel stable about what your doing, alot times in the past, i've done good work, yet untreated, i've been off the charts so much people take a picture of me! trip over stuff...wire's get tanglged (wanna stranggle myself with/one sometimes) Go in circles, even in parkin lot's, "i was just here" due! danm'd 26th time i've gone in the same place, now where that parkin place....some people just don't know what some one's life hell is....so get some insight.
Low doses can help with some/sleep......because i've realized, at night just to focus on getting to sleep, i cannot. Wireless brainless static eletricity going everywhere! Have this magnetic feeling between the nose and forehead.
High doses, will cause "obession" w/something. You become intrested in some boring book your don't want to read, it activates new insight.
That's my say, now being not treated, 100% i'm doing fine, yes! thank you lord! Do doctor's know what this does? get a reality check....knock knock....
rj
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