quetiapine-fumarate and Restless-Legs-Syndrome

We report on seven cases of restless legs syndrome (RLS) in patients treated with quetiapine. Small doses (50-250 mg at bedtime) provoked RLS in a dose-dependent way. Most patients suffered from an affective disorder and all were treated concomitantly with antidepressants. A search of the literature revealed a further nine cases of RLS concerning quetiapine, also afflicting only patients with affective disorders. Quetiapine seems to carry a special risk for RLS in this sort of patient. Possible causes for this concurrence are discussed.

Topics: Adult; Aged; Antipsychotic Agents; Dibenzothiazepines; Female; Humans; Male; Mental Disorders; Middle Aged; Quetiapine Fumarate; Restless Legs Syndrome

Akathisia (restlessness and characteristic movements of the legs) is one of the most disagreeable extrapyramidal side effects and often causes non-compliance. Dopamine blocking agents such as antipsychotics and antiemetics, may induce akathisia. Particular care must be taken to distinguish akathisia from psychotic agitation and restless legs. The prevalence of akathisia in patients using classical antipsychotics is 20-30% and for users of clozapine, olanzapine and quetiapine (atypical antipsychotics) it is lower. Risk factors are a high dosage of antipsychotics, akathisia in a previous treatment, and diabetes mellitus. The treatment of akathisia starts, if possible, with the antipsychotic being withdrawn or the dose administered being lowered. Another treatment possibility is switching to clozapine, olanzapine or quetiapine, or adding a beta-blocking agent, an anticholinergic or mianserin.

Topics: Akathisia, Drug-Induced; Antipsychotic Agents; Benzodiazepines; Clozapine; Diabetes Complications; Diagnosis, Differential; Dibenzothiazepines; Dose-Response Relationship, Drug; Humans; Olanzapine; Pirenzepine; Prevalence; Psychomotor Agitation; Quetiapine Fumarate; Recurrence; Restless Legs Syndrome; Risk Factors

Restless arms syndrome (RAS) is characterized by uncomfortable aching or burning sensations in the arms. RAS is regarded as an upper limb variant of restless legs syndrome (RLS). The lack of specific diagnostic criteria makes it difficult to recognize the RAS. Therefore, RAS is usually neglected in clinical practice. Moreover, when a patient was diagnosed with RAS, the adjustment of medications was the first choice for doctors, which may make the patient's condition unstable.. A 33-year-old woman was diagnosed with schizophrenia and major depressive disorder. Starting with 0.6 g/d amisulpride, 0.1 g/d quetiapine, 75 mg/d venlafaxine sustained-release tablets, the patient reported symptoms of RAS (itching arms) on the fourth day since the latest hospitalization. After ruling out other factors, her RAS was suspected to be induced by antidepressants or antipsychotics. Without medication adjustment, RAS spontaneously remitted.. This case suggests that psychiatrists should pay attention to RAS when using antipsychotics and/or antidepressants. Moreover, RAS may be transitory. When a patient manifests RAS, observation may be one choice instead of an immediate medication adjustment.

Topics: Adult; Antidepressive Agents; Antipsychotic Agents; Depressive Disorder, Major; Female; Humans; Quetiapine Fumarate; Restless Legs Syndrome

Restless legs syndrome is an underdiagnosed sensori-motor disorder and psychotropic drugs are one of the main secondary causes of the illness. The most common psychotropic agents that cause restless legs syndrome are antidepressants; however, antipsychotics have also been reported to induce restless legs syndrome. The prevalence, vulnerability factors and the underlying mechanism of antipsychotic-induced restless legs syndrome are unclear. A possible explanation is that dopaminergic blockade is the main precipitator of the syndrome. Quetiapine-induced restless legs syndrome is another point of interest because of its low binding to D2 receptors. We herein report the case of a restless legs syndrome that emerged after a single low dose quetiapine administration.

Topics: Adult; Antipsychotic Agents; Female; Humans; Quetiapine Fumarate; Restless Legs Syndrome

Topics: Adult; Antipsychotic Agents; Bipolar Disorder; Depressive Disorder; Female; Humans; Psychotic Disorders; Quetiapine Fumarate; Restless Legs Syndrome

Topics: Antidepressive Agents, Second-Generation; Antipsychotic Agents; Benzodiazepines; Bipolar Disorder; Cyclohexanols; Dibenzothiazepines; Drug Substitution; Drug Therapy, Combination; Female; Humans; Middle Aged; Olanzapine; Quetiapine Fumarate; Restless Legs Syndrome; Treatment Outcome; Venlafaxine Hydrochloride

Topics: Adult; Akathisia, Drug-Induced; Antipsychotic Agents; Dibenzothiazepines; Humans; Male; Quetiapine Fumarate; Restless Legs Syndrome

Topics: Antidepressive Agents, Second-Generation; Antipsychotic Agents; Bipolar Disorder; Dibenzothiazepines; Drug Therapy, Combination; Humans; Male; Middle Aged; Paroxetine; Quetiapine Fumarate; Restless Legs Syndrome

Topics: Antipsychotic Agents; Bipolar Disorder; Dibenzothiazepines; Dopamine Agonists; Female; Humans; Indoles; Middle Aged; Quetiapine Fumarate; Restless Legs Syndrome; Treatment Outcome

Topics: Aged; Antipsychotic Agents; Dibenzothiazepines; Dose-Response Relationship, Drug; Female; Humans; Periodicity; Quetiapine Fumarate; Restless Legs Syndrome

According to some reports, patients treated with risperidone may develop akathisia. Restless legs syndrome (RLS), which shares some clinical features with akathisia, is a distinct movement and sleep disorder that may be induced by various drugs that act on the CNS.. We studied a 31-year-old patient suffering from a schizoaffective disorder including auditory hallucinations who developed symptoms typical of the RLS during treatment with risperidone, using polysomnography to objectify sleep disturbances and associated periodic leg movements during sleep (PLMS).. After switching from clozapine to risperidone treatment, the patient complained about dysethesias primarily of the legs, an urge to walk around, and sleep disturbances. The latter could be confirmed by polysomnography, including an abnormal PLMS index. Risperidone was switched to haloperidol. However, RLS symptoms were still present. After switching to quetiapine, RLS symptoms vanished and a second polysomnography test demonstrated better sleep quality and normal PLMS measurements. During the whole treatment period with different neuroleptics, the patient additionally received valproic acid.. Symptoms typical of RLS may be induced by risperidone treatment and should be differentiated from akathisia. Although polysomnography is not necessary, it may be helpful confirming the diagnosis.

Topics: Adult; Antipsychotic Agents; Dibenzothiazepines; Female; Humans; Polysomnography; Quetiapine Fumarate; Restless Legs Syndrome; Risperidone; Sleep; Valproic Acid