title: Augmentation of restless legs syndrome with long-term tramadol treatment.
abstract: 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.
authors.affiliation: Department of Neurological Sciences, University of Bologna, Bologna, Italy. vetrugno@neuro.unibo.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Vetrugno
authors.forename: Chiara
authors.initials: C
authors.lastname: La Morgia
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Angelo
authors.forename: Daniela
authors.initials: D
authors.lastname: Loi
authors.forename: Federica
authors.initials: F
authors.lastname: Provini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
authors.forename: Pasquale
authors.initials: P
authors.lastname: Montagna
mesh_terms: 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*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol