Augmentation of restless legs syndrome with long-term tramadol treatment.
Restless legs syndrome (RLS) augmentation, defined as a kind of suppression of the circadian rhythm of the disease in which sensory and motor symptoms appear earlier during the day (and over previously unaffected body parts), with a progressive phase advance until, backwards, the symptoms may cover the entire day, has been described only after treatment with dopaminergic drugs. We report clinical and polysomnographic accounts of a patient developing RLS augmentation after long-term treatment with tramadol, an opioid agonist with selectivity for mu-receptor and added norepinephrine and serotonin reuptake inhibition properties. Polysomnographic measures showed an improvement of RLS and a disappearance of diurnal sensory and motor RLS symptoms after tramadol was stopped. Our case confirms a recent retrospective report of augmentation of RLS after treatment with tramadol, and begs the question whether augmentation is truly restricted to dopaminergic drugs.
Vetrugno
Roberto
R
Department of Neurological Sciences, University of Bologna, Bologna, Italy. vetrugno@neuro.unibo.it
La Morgia
Chiara
C
D'Angelo
Roberto
R
Loi
Daniela
D
Provini
Federica
F
Plazzi
Giuseppe
G
Montagna
Pasquale
P
D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects*; D004357:Drug Synergism; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010292:Paresthesia / Q000188:drug therapy; D017286:Polysomnography; D012148:Restless Legs Syndrome / Q000139:chemically induced*; D014147:Tramadol / Q000009:adverse effects*
D000701:Analgesics, Opioid; D014147:Tramadol