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    <title>RLS CHAT</title>
    <link>http://www.rlschat.com/index.php</link>
    <description><![CDATA[]]></description>
    <language>EN</language>
    <pubDate>Tue, 24 Apr 2007 03:34:00 -0700</pubDate>
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    <category>RLS CHAT</category>
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    <item>
      <title>[New Medicines For RLS] Here is Drugs Table....</title>
      <link>http://www.rlschat.com/read.php?16,86,87#msg-87</link>
      <author>suren</author>
      <description><![CDATA[Treatment strategies for RLS

Drugs Specific Issues Dose Range 
Dopaminergic: (Usually first choice): 
      
Levodopa DCI Rebound/Augmentation 
Useful for intermittent RLS 100-600mg
evening or divided close 
      
Bromocriptine Poor tolerance
(Preferably avoided)  7.5mg (divided dose) 
      
Pergolide Augmentation reported rarely 0.1 - 0.75mg od/bid 
      
Ropinirole No Aaugmentation reported  0.5-4 mg od/bid 
      
Pramipexole Augmentation reported rarely  1.5 mg (salt) od/bid/td 
      
Cabergoline 24 hour action
No augmentation reported 0.5-4 mg (single evening dose) 
      
Apomorphine Specialist monitoring required  18-50 mg/12 hrs Overnight sc infusion 
      
Rotigotine Skin patch currently in trial 1.125-4.5mg 
      
Other drugs:     
      
Gabapentin Quick dose escalation
Useful second line agent
Painful RLS 300-2400 mg 
      
Carbamazepine Single/divided doses  100 -600 mg 
      
Oxycodon Painful RLS 2.5-25mg 
      
Propoxyphene As above 100-260 mg 
      
Clonazepam Drowsiness
Useful for associated insomnia 0.5-2 mg
evening close 
      
Triazolam As above 0.125/0.25 mg 
      
Nitrazepam As above 2.5 - 10 mg 
      
Clonidine Uraemia 0.15-0.9 mg 
      
Iron sulphate Iron defieciency
(low ferritin levels) 200mg tid Oral]]></description>
      <category>New Medicines For RLS</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?16,86,87#msg-87</guid>
      <pubDate>Tue, 24 Apr 2007 03:34:00 -0700</pubDate>
    </item>
    <item>
      <title>[New Medicines For RLS] Specific Issues with Drug Treatment</title>
      <link>http://www.rlschat.com/read.php?16,86,86#msg-86</link>
      <author>hemant</author>
      <description><![CDATA[The drugs used for the treatment of RLS have a number of side effects and caution is needed in certain situations. Levodopa was regarded as the first line treatment of RLS, however many patients develop rebound (occurrence of symptoms during the night) or augmentation (symptoms occur earlier in the day before levodopa dosing in the evening and may also involve the trunk or upper limbs). Augmentation affects up to 82% of patients treated with levodopa and therefore its use in the long-term is limited in most cases.

Most dopamine agonists have been shown to be effective for RLS. These treatments are preferential in the long-term treatment of RLS as they are long-acting preparations that can be taken as a single dose at bedtime. These drugs have been reported to alleviate symptoms in 70 - 100% of patients. Treatment with some dopamine agonists can also lead to augmentation but this is usually mild and can be treated by increasing the dose. The most common adverse effect of these drugs is nausea, which can be counteracted by domperidone.

Levodopa and the dopamine agonists are to be used with caution in angle-closure glaucoma or if there is a history of malignant melanoma. Close monitoring is required if patients have cardiac disease or peptic ulcer disease. Many patients experience gastrointestinal effects as a result of levodopa use. These include anorexia, nausea and vomiting. Other practical issues in relation to therapy include: 
The age of the patient should be taken into account (for example benzodiazepines may cause cognitive impairment in the elderly). 
Use medication cautiously in pregnancy as there are no controlled clinical trials that have assessed the safety of medications in RLS and pregnancy. Furthermore, RLS symptoms usually improve after parturition.]]></description>
      <category>New Medicines For RLS</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?16,86,86#msg-86</guid>
      <pubDate>Tue, 24 Apr 2007 03:32:17 -0700</pubDate>
    </item>
    <item>
      <title>[New Medicines For RLS] here INFO for DRUG TREATMENT</title>
      <link>http://www.rlschat.com/read.php?16,84,85#msg-85</link>
      <author>hemant</author>
      <description><![CDATA[No drugs are currently licensed for treatment of RLS in the UK or USA. However, a large number of drugs have been used after clinical trials in RLS. In particular, dopamine agonists have been shown to be effective based on placebo controlled randomised trials. The drugs used in RLS generally belong to the following classes:

A: Dopaminergic agents (Levodopa, dopamine agonists, amantadine; these drugs are also used in Parkinson's disease)
B: Anti-epileptic drugs
C: Opioids
D: Benzodiazepines
E: Iron
F: Miscellaneous

Although the evidence base for treatment of RLS is not robust, clinically it may be useful to adopt a step by step approach to treating RLS. The options include: 
Start treatment with a dopamine agonist (all newer agonists such as pergolide, cabergoline, pramipexole and ropinirole are effective and should be given as a single dose in the evening). 
If patients are intolerant to dopamine agonists then levodopa (Sinemet or Madopar) should be given at night-time before bed. 80-82% of paitents taking levodopa may develop augmentation or rebound. 
If levodopa is no longer effective or if symptoms start appearing in the early morning (rebound phenomenon) or evening/daytime with spread to upper limb (augmentation), then dopamine agonists may be reintroduced. At this stage cabergoline may be particularly useful as this drug works given once daily. Dopamine agonists with shorter half-life may need to be given up to 3 times a day. 
If symptoms are resistant then an antiepileptic drug such as carbamazepine or gabapentin may be tried. These drugs inhibit the hyperactivity of the nervous system that may be related to the symptoms. Gabapentin may be particularly useful for haemodialysis patients because it is dialyzable and has a long half-life, and for 'painful' RLS. 
Severe unremitting painful RLS may need to be treated by strong painkillers such as Codeine, Tramadol, Oxycodone or Propoxyphene under specialist guidance 
Bedtime sedatives such as clonazepam or zopiclone may be useful in some cases with severe insomnia. These may also exert a beneficial effect by reducing nervous activity and by increasing muscle relaxation. 
In some severe cases unresponsive to above, patients may need hospitalisation and treatment with subcutaneous apomorphine given overnight by a pump in specialist centres.]]></description>
      <category>New Medicines For RLS</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?16,84,85#msg-85</guid>
      <pubDate>Tue, 24 Apr 2007 03:31:38 -0700</pubDate>
    </item>
    <item>
      <title>[New Medicines For RLS] Non-drug Treatment</title>
      <link>http://www.rlschat.com/read.php?16,84,84#msg-84</link>
      <author>suren</author>
      <description><![CDATA[Firstly it is worth noting that the severity and frequency of RLS symptoms vary greatly between individuals. Mild RLS may not require medical treatment. Initially reassurance should be offered and lifestyle changes may be useful. Secondary causes must be corrected. Dietary supplementation with iron if anaemia is a cause, mineral supplements (magnesium, potassium and calcium) and good sleep hygiene and habits are useful. 
Some drugs may worsen RLS and include antidepressants, calcium blocker drugs (used to treat high blood pressure), anti-nausea medications except domperidone, high intake of caffeine and some antiallergy medications.
The following activities during an attack of RLS may be helpful: 
Walking and stretching 
Hot or cold bath 
Relaxation exercises (biofeedback or yoga) 
Having an engaging discussion or activity during sitting to distract mind 
Massaging affected limbs]]></description>
      <category>New Medicines For RLS</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?16,84,84#msg-84</guid>
      <pubDate>Tue, 24 Apr 2007 03:29:51 -0700</pubDate>
    </item>
    <item>
      <title>[Clinical Trails For RLS] Recently Published on RLS Trials</title>
      <link>http://www.rlschat.com/read.php?14,82,83#msg-83</link>
      <author>hemant</author>
      <description><![CDATA[Recently Published Trials:

Goldberg J, Burdick KE, Endick CJ. 2004.Preliminary randomized placebo-controlled trial of pramipexole added to mood stabilizers for treatment resistant bipolar depression. Am J Psychiatry, 161:564-6.

Happe S, Sauter C, Klosch G et al. 2003. Gabapentin versus ropinirole in the treatment of idiopathic restless legs syndrome. Neuropsychobiology, 48:82-6. 

Oertel W, Stiasny-Kolster K. Effective treatment of restless legs syndrome (RLS) with pramiexole: results of a 6 week, multi-centre, double blind and placebo controlled study. Eur J Neurology 2005;12(s2):P2205 (abstract)

Ondo WG. Methadone for refarctory restless legs syndrome. 2005. Mov Disord, 20:345-8.

Partinen M, Hirvonen K, Alakuijala A, et al. 2004. Rapid relief from RLS symptoms with pramipexole: results of a large polysomnographic study. Neurology, 2004; 62(7, Suppl 5):LBS.002 

Stiasny-Kolster K, Benes H, Peglau I, et al. 2004a. Effective cabergoline treatment in idiopathic restless legs syndrome. Neurology, 63:2272-9.

Stiasny-Kolster K, Kohnen R, Schollmayer E, et al. 2004b. The Rotigotine Sp 666 Study Group. Patch application of the dopamine agonist rotigotine to patients with moderate to advanced stages of restless legs syndrome: A double-blind, placebo-controlled pilot study. Mov Disord, 19:1432-8.

Trenkwalder C, Garcia-Borreguero D, Montagna P, et al. 2004a. Therapy with ropinirole; efficacy and tolerability in RLS. TREAT RLS 1 Study Group. J Neurol Neurosurg Psychiatry, 75:92-7.

Trenkwalder C, Hundemer HP, Lledo A, et al. PEARLS Study Group. 2004b. Efficacy of pergolide intreatment of restless legs syndrome: the PEARLS study. Neurology, 62:1391-7. 

Walters AS, Ondo WG, Dreykluft T, et al. on behalf of the TREAT RLS 2 (Therapy with Ropinirole: Efficacy And Tolerability in RLS 2) Study Group. 2004. Ropinirole is effective in the treatment of restless legs syndrome. TREAT RLS 2: A 12-week, double-blind, randomized, parallel-group, placebo-controlled study. Mov Disord, 19:1414-23.]]></description>
      <category>Clinical Trails For RLS</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?14,82,83#msg-83</guid>
      <pubDate>Tue, 24 Apr 2007 03:24:09 -0700</pubDate>
    </item>
    <item>
      <title>[Clinical Trails For RLS] Clinical Trials and New Research</title>
      <link>http://www.rlschat.com/read.php?14,82,82#msg-82</link>
      <author>suren</author>
      <description><![CDATA[Several compounds have undergone or undergoing clinical trials in RLS. The trial with Sumanirole, a dopamine agonist has been discontinued.

Robust trial data from double blind placebo controlled studies performed in a reasonable number of patients ranging from 80-350 have been published in relation to cabergoline, pergolide, ropinirole, rotigotine and pramipexole (the latter in an abstract version). All show significant superiority of dopamine agonists compared to placebo.]]></description>
      <category>Clinical Trails For RLS</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?14,82,82#msg-82</guid>
      <pubDate>Tue, 24 Apr 2007 03:22:09 -0700</pubDate>
    </item>
    <item>
      <title>[Latest News On RLS] The Diagnosis and Management of Restless Legs Syndrome</title>
      <link>http://www.rlschat.com/read.php?13,80,81#msg-81</link>
      <author>hemant</author>
      <description><![CDATA[The material presented here does not necessarily reflect the views of Medscape or companies that support educational programming on www.medscape.com. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed.]]></description>
      <category>Latest News On RLS</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?13,80,81#msg-81</guid>
      <pubDate>Tue, 24 Apr 2007 03:15:34 -0700</pubDate>
    </item>
    <item>
      <title>[Latest News On RLS] latest news on RLS Project Launches in Dundee</title>
      <link>http://www.rlschat.com/read.php?13,80,80#msg-80</link>
      <author>suren</author>
      <description><![CDATA[The RLS Project has had a strong start, with a number of collections already online, and the rest well under way. This is an exciting time, as all involved start to see the fruits of their work and the interaction between the disparate collections that makes RLS such a valuable learning resource. Some of the collections filling our virtual library shelves at the moment include the superb Images of War, 1916 &amp;#65533;€“ 1918. This collection contains 2,100 digitized photographs, primarily from the Field Marshal Haig&amp;#65533;€™s personal photograph file in the Haig Papers, taken by War Office photographers. Another collection looks at &amp;#65533;€˜The Black Art of Photography&amp;#65533;€™ &amp;#65533;€“ nothing to do with witchcraft, as the name might suggest, but an illustration of the art and science of Victorian Photographer Magnus Jackson! In the future, we can look forward exciting collections such as &amp;#65533;€˜Sites to See&amp;#65533;€™ from Historic Scotland, &amp;#65533;€˜Historical Maps&amp;#65533;€™ from the National Library of Scotland and &amp;#65533;€˜Treasures from the Scottish Screen Archive&amp;#65533;€™. There are many more collections coming from around Scotland.]]></description>
      <category>Latest News On RLS</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?13,80,80#msg-80</guid>
      <pubDate>Tue, 24 Apr 2007 03:08:03 -0700</pubDate>
    </item>
    <item>
      <title>[About RlsChat] Has anyone tried the new drugs available for RLS ?</title>
      <link>http://www.rlschat.com/read.php?12,79,79#msg-79</link>
      <author>araiyah</author>
      <description><![CDATA[Has anyone tried the new drugs available for RLS ? Any feedback?]]></description>
      <category>About RlsChat</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?12,79,79#msg-79</guid>
      <pubDate>Tue, 17 Apr 2007 11:55:12 -0700</pubDate>
    </item>
    <item>
      <title>[Restless Legs Syndrome Fact Sheet] Re: How is restless legs syndrome diagnosed?</title>
      <link>http://www.rlschat.com/read.php?11,77,78#msg-78</link>
      <author>Anonymous User</author>
      <description><![CDATA[The diagnosis is especially difficult with children because the physician relies heavily on the patient's explanations of symptoms, which, given the nature of the symptoms of RLS, can be difficult for a child to describe. The syndrome can sometimes be misdiagnosed as &quot;growing pains&quot; or attention deficit disorder.]]></description>
      <category>Restless Legs Syndrome Fact Sheet</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?11,77,78#msg-78</guid>
      <pubDate>Thu, 12 Apr 2007 01:30:07 -0700</pubDate>
    </item>
    <item>
      <title>[Restless Legs Syndrome Fact Sheet] How is restless legs syndrome diagnosed?</title>
      <link>http://www.rlschat.com/read.php?11,77,77#msg-77</link>
      <author>Anonymous User</author>
      <description><![CDATA[Currently, there is no single diagnostic test for RLS. The disorder is diagnosed clinically by evaluating the patient's history and symptoms. Despite a clear description of clinical features, the condition is often misdiagnosed or underdiagnosed. In 1995, the International Restless Legs Syndrome Study Group identified four basic criteria for diagnosing RLS: (1) a desire to move the limbs, often associated with paresthesias or dysesthesias, (2) symptoms that are worse or present only during rest and are partially or temporarily relieved by activity, (3) motor restlessness, and (4) nocturnal worsening of symptoms. Although about 80 percent of those with RLS also experience PLMD, it is not necessary for a diagnosis of RLS. In more severe cases, patients may experience dyskinesia (uncontrolled, often continuous movements) while awake, and some experience symptoms in one or both of their arms as well as their legs. Most people with RLS have sleep disturbances, largely because of the limb discomfort and jerking. The result is excessive daytime sleepiness and fatigue. 

Despite these efforts to establish standard criteria, the clinical diagnosis of RLS is difficult to make. Physicians must rely largely on patients' descriptions of symptoms and information from their medical history, including past medical problems, family history, and current medications. Patients may be asked about frequency, duration, and intensity of symptoms as well as their tendency toward daytime sleep patterns and sleepiness, disturbance of sleep, or daytime function. If a patient's history is suggestive of RLS, laboratory tests may be performed to rule out other conditions and support the diagnosis of RLS. Blood tests to exclude anemia, decreased iron stores, diabetes, and renal dysfunction should be performed. Electromyography and nerve conduction studies may also be recommended to measure electrical activity in muscles and nerves, and Doppler sonography may be used to evaluate muscle activity in the legs. Such tests can document any accompanying damage or disease in nerves and nerve roots (such as peripheral neuropathy and radiculopathy) or other leg-related movement disorders. Negative results from tests may indicate that the diagnosis is RLS. In some cases, sleep studies such as polysomnography (a test that records the patient's brain waves, heartbeat, and breathing during an entire night) are undertaken to identify the presence of PLMD.]]></description>
      <category>Restless Legs Syndrome Fact Sheet</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?11,77,77#msg-77</guid>
      <pubDate>Thu, 12 Apr 2007 01:29:29 -0700</pubDate>
    </item>
    <item>
      <title>[About RlsChat] please tell how you feel about RlsChat</title>
      <link>http://www.rlschat.com/read.php?12,76,76#msg-76</link>
      <author>Anonymous User</author>
      <description><![CDATA[this board is created to find out the ideas about our work as &quot;RlsChat&quot;. If any one have word's to say, you can continue from here.]]></description>
      <category>About RlsChat</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?12,76,76#msg-76</guid>
      <pubDate>Thu, 12 Apr 2007 01:28:23 -0700</pubDate>
    </item>
    <item>
      <title>[Restless Legs Syndrome Fact Sheet] common signs and symptoms of restless legs?</title>
      <link>http://www.rlschat.com/read.php?11,74,75#msg-75</link>
      <author>Anonymous User</author>
      <description><![CDATA[As described above, people with RLS feel uncomfortable sensations in their legs, especially when sitting or lying down, accompanied by an irresistible urge to move about. These sensations usually occur deep inside the leg, between the knee and ankle; more rarely, they occur in the feet, thighs, arms, and hands. Although the sensations can occur on just one side of the body, they most often affect both sides. 

Because moving the legs (or other affected parts of the body) relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations. They may pace the floor, constantly move their legs while sitting, and toss and turn in bed. 

Most people find the symptoms to be less noticeable during the day and more pronounced in the evening or at night, especially during the onset of sleep. For many people, the symptoms disappear by early morning, allowing for more refreshing sleep at that time. Other triggering situations are periods of inactivity such as long car trips, sitting in a movie theater, long-distance flights, immobilization in a cast, or relaxation exercises. 

The symptoms of RLS vary in severity and duration from person to person. Mild RLS occurs episodically, with only mild disruption of sleep onset, and causes little distress. In moderately severe cases, symptoms occur only once or twice a week but result in significant delay of sleep onset, with some disruption of daytime function. In severe cases of RLS, the symptoms occur more than twice a week and result in burdensome interruption of sleep and impairment of daytime function. 

Symptoms may begin at any stage of life, although the disorder is more common with increasing age. Sometimes people will experience spontaneous improvement over a period of weeks or months. Although rare, spontaneous improvement over a period of years also can occur. If these improvements occur, it is usually during the early stages of the disorder. In general, however, symptoms become more severe over time. 

People who have both RLS and an associated condition tend to develop more severe symptoms rapidly. In contrast, those whose RLS is not related to any other medical condition and whose onset is at an early age show a very slow progression of the disorder and many years may pass before symptoms occur regularly.]]></description>
      <category>Restless Legs Syndrome Fact Sheet</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?11,74,75#msg-75</guid>
      <pubDate>Thu, 12 Apr 2007 01:22:44 -0700</pubDate>
    </item>
    <item>
      <title>[Restless Legs Syndrome Fact Sheet] Restless Legs Syndrome Fact Sheet</title>
      <link>http://www.rlschat.com/read.php?11,74,74#msg-74</link>
      <author>Anonymous User</author>
      <description><![CDATA[What is restless legs? 



Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described by people as burning, creeping, tugging, or like insects crawling inside the legs. Often called paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), the sensations range in severity from uncomfortable to irritating to painful. 

The most distinctive or unusual aspect of the condition is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes exhaustion and daytime fatigue. Many people with RLS report that their job, personal relations, and activities of daily living are strongly affected as a result of their exhaustion. They are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks. 

Some researchers estimate that RLS affects as many as 12 million Americans. However, others estimate a much higher occurrence because RLS is thought to be underdiagnosed and, in some cases, misdiagnosed. Some people with RLS will not seek medical attention, believing that they will not be taken seriously, that their symptoms are too mild, or that their condition is not treatable. Some physicians wrongly attribute the symptoms to nervousness, insomnia, stress, arthritis, muscle cramps, or aging. 

RLS occurs in both genders, although the incidence may be slightly higher in women. Although the syndrome may begin at any age, even as early as infancy, most patients who are severely affected are middle-aged or older. In addition, the severity of the disorder appears to increase with age. Older patients experience symptoms more frequently and for longer periods of time.]]></description>
      <category>Restless Legs Syndrome Fact Sheet</category>
      <guid isPermaLink="true">http://www.rlschat.com/read.php?11,74,74#msg-74</guid>
      <pubDate>Thu, 12 Apr 2007 01:21:24 -0700</pubDate>
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