Restless legs syndrome and periodic limb movements during sleep probably associated with olanzapine.
We report five cases of restless legs syndrome (RLS) and periodic limb movements during sleep (PLMS) that were probably associated with olanzapine. The first patient showed a good response to olanzapine, but the RLS symptoms associated with olanzapine resulted in poor long-term compliance, eventually leading to frequent relapse of psychotic symptoms. The second patient exhibited sudden PLMS following olanzapine injection. The third patient had been suffering from serious akathisia while on risperidone, and was cured after switching to olanzapine, but thereafter the patient suffered from RLS at nighttime. The fourth patient showed RLS symptoms that were initially caused by a 20-mg daily olanzapine dosage and were later mitigated when olanzapine was reduced and ropinirole was administered. The fifth patient exhibited paraesthesia and agitation caused by olanzapine that was misdiagnosed as psychotic agitation. Increasing the olanzapine dosage severely aggravated the symptoms of RLS. Antipsychotic-induced RLS and PLMS are not well-recognized side effects of antipsychotics, with the symptoms often misdiagnosed as psychotic agitation. These cases also suggest that the occurrence of RLS can cause noncompliance with antipsychotics in psychiatric patients, and thus aggravate their psychotic symptoms.
Department of Psychiatry, Division of Brain Korea 21 Biomedical Science, Korea University College of Medicine, Seoul 136-705, Korea.
Seung-Gul
SG
Kang
Heon-Jeong
HJ
Lee
Leen
L
Kim
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D001523:Mental Disorders / Q000188:drug therapy; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000139:chemically induced*; D000077152:Olanzapine; D012148:Restless Legs Syndrome / Q000139:chemically induced*
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine