The Use of Dopamine Agonist in the Treatment of Restless Legs Syndrome: Caution for Practitioners and Bipolar Patients

摘要

Restless legs syndrome (RLS) is a commonly "undiag-nosed and untreated" pathology seen in the primary care physicians' (PCP) office. One particular area of concern is in treating patients with comorbid psychiatric issues. Of primary concern is the bipolar patient who is often unrecognized and treated by the PCP.Most patients being treated for depression are being seen by their PCP, who actually write the majority of prescriptions for antidepressants. Many patients fail multiple trials of antidepressants and are considered treatment resistant. A portion of these patients are diagnosed with comorbid anxiety and represent a higher risk of suicide. Some of these patients may actually be suffering from bipolar disorder (BD).BD is a highly recurrent and severe illness, with high rates of suicidality and functional impairment. The disorder is heritable and appears to share susceptibility genes with schizophrenia. It is characterized by dysregulation in the dopamine and serotonin systems, and by pathology in the brain systems involved in regulating emotion.8 More PCPs are being called to treat this disorder as the numbers of psychiatrists are limited.