title: Restless legs syndrome and drug-induced akathisia in headache patients.
abstract: The purpose of the research presented in this article was to characterize restless leg syndrome (RLS) in a headache population and correlate treatment induced risks with dopamine blockers. Fifty patients with severe headache who were admitted to an outpatient infusion center were enrolled. The diagnosis of RLS was established using the International Restless Leg Syndrome Study Group criteria. Patients were screened for baseline akathisia using an akathisia scale and reexamined for akathisia after receiving intravenous infusion with one of four dopamine receptor blocking agents as treatment for their headaches. A change from baseline to post-infusion assessment of two points on a global assessment of akathisia was considered positive for drug-induced akathisia. Our results indicated that 41 (82%) of patients had episodic or chronic migraine. The rest had new daily persistent headache, cluster, or posttraumatic headache. Seventeen subjects (34%) met the criteria for RLS. Nineteen (38%) of the subjects developed drug-induced akathisia. Thirteen (76.5%) of the subjects with RLS developed akathisia compared with only 6 of the 33 (18.2%) without RLS (P<.0001). Finally, we concluded that headache patients with RLS are at a greatly increased risk of developing drug-induced akathisia when treated with intravenous dopamine receptor blocking agents.
authors.affiliation: Department of Neurology, Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA. william.b.young@mail.tju.edu
authors.forename: William B
authors.initials: WB
authors.lastname: Young
authors.forename: Elcio J
authors.initials: EJ
authors.lastname: Piovesan
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Biglan
mesh_terms: D000293:Adolescent; D000328:Adult; D017109:Akathisia, Drug-Induced / Q000209:etiology*; D002352:Carrier Proteins / Q000378:metabolism; D018492:Dopamine Antagonists / Q000009:adverse effects*; D005260:Female; D005293:Ferritins / Q000172:deficiency; D006261:Headache / Q000150:complications*; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins; D007501:Iron / Q000627:therapeutic use; D008297:Male; D009479:Neuropeptides / Q000378:metabolism; D000068797:Orexins; D012148:Restless Legs Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D002352:Carrier Proteins; D018492:Dopamine Antagonists; D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D000068797:Orexins; D005293:Ferritins; D007501:Iron