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BMC Psychiatry

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Open Access 01-12-2021 | Antidepressant Drugs | Case report

Transitory restless arms syndrome in a patient with antipsychotics and antidepressants: a case report

Authors: Juan Chen, Na Meng, Bingrong Cao, Yinghua Ye, Ying Ou, Zhe Li

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

Restless arms syndrome (RAS) is characterized by uncomfortable aching or burning sensations in the arms. RAS is regarded as an upper limb variant of restless legs syndrome (RLS). The lack of specific diagnostic criteria makes it difficult to recognize the RAS. Therefore, RAS is usually neglected in clinical practice. Moreover, when a patient was diagnosed with RAS, the adjustment of medications was the first choice for doctors, which may make the patient’s condition unstable.

Case presentation

A 33-year-old woman was diagnosed with schizophrenia and major depressive disorder. Starting with 0.6 g/d amisulpride, 0.1 g/d quetiapine, 75 mg/d venlafaxine sustained-release tablets, the patient reported symptoms of RAS (itching arms) on the fourth day since the latest hospitalization. After ruling out other factors, her RAS was suspected to be induced by antidepressants or antipsychotics. Without medication adjustment, RAS spontaneously remitted.

Conclusions

This case suggests that psychiatrists should pay attention to RAS when using antipsychotics and/or antidepressants. Moreover, RAS may be transitory. When a patient manifests RAS, observation may be one choice instead of an immediate medication adjustment.

Ruppert E. Restless arms syndrome: prevalence, impact, and management strategies. Neuropsychiatr Dis Treat. 2019;15:1737–50. https://doi.org/10.2147/NDT.S161583.CrossRefPubMedPubMedCentral

Ruppert E, Cretin B, Meyer C, Kilic-Huck U, Bourgin P. Characterization of periodic upper limb movement disorder in a patient with restless arms syndrome. Mov Disord. 2012;27(11):1459–61. https://doi.org/10.1002/mds.25154.CrossRefPubMed

Ruppert E, Tranchant C, Kilic-Huck U, Carpentier N, Bataillard M, Bourgin P. Bedtime-related jerks in the upper limbs associated with restless arms syndrome. Neurology. 2015;84(9):959. https://doi.org/10.1212/WNL.0000000000001306.CrossRefPubMed

Konstantakopoulos G, Oulis P, Michalopoulou P, Papadimitriou G. "Restless arms syndrome" Associated with Olanzapine European Psychiatry. 2009;24:1007.

Munhoz RP, Arruda WO, Teive HA. An upper limb variant of RLS? Report of 2 cases. Clin Neurol Neurosurg. 2012;114(3):265–6. https://doi.org/10.1016/j.clineuro.2011.10.016.CrossRefPubMed

Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, et al. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated international restless legs syndrome study group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med. 2014;15(8):860–73. https://doi.org/10.1016/j.sleep.2014.03.025.CrossRefPubMed

Michaud M, Chabli A, Lavigne G, Montplaisir J. Arm restlessness in patients with restless legs syndrome. Mov Disord. 2000;15(2):289–93. https://doi.org/10.1002/1531-8257(200003)15:2%3C289::AID-MDS1012%3E3.0.CO;2-E.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Washington, DC: American Psychiatric Publishing; 2013.

International Restless Legs Syndrome Study Group. Diagnostic-criteria. 2012. http://www.irlssg.org/Diagnostic-criteria. Accessed 1 Dec 2012.

10.

Walters AS, Hening W, Rubinstein M, Chokroverty S. A clinical and polysomnographic comparison of neuroleptic-induced akathisia and the idiopathic restless legs syndrome. Sleep. 1991;14(4):339–45.PubMed

11.

Park Y-M. Restless legs syndrome caused by quetiapine. Chronobiology in Medicine. 2020;2(1):21–4. https://doi.org/10.33069/cim.2019.0030.CrossRef

12.

Soyata AZ, Celebi F, Yargc LI. Restless legs syndrome after single low dose quetiapine administration. Curr Drug Saf. 2016;11(2):172–3. https://doi.org/10.2174/1574886311207040298.CrossRefPubMed

13.

Semiz M, Solmaz V, Aksoy D, Inanir S, Colak B, Gokbakan MA, et al. Prevalence of restless legs syndrome among psychiatric patients who are under antidepressant or antipsychotic monotherapy. Bull Clin Psychopharmacol. 2016;26(2):161–8. https://doi.org/10.5455/bcp.20150908024954.CrossRef

14.

Colle R, Boichot F, Bouteiller E, Elie-Lefebvre C, Hardy P, David DJ, et al. Restless legs syndrome and schizophrenia: a case report. J Clin Psychopharmacol. 2018;38(1):91–2. https://doi.org/10.1097/JCP.0000000000000832.CrossRefPubMed

15.

Boku S, Hirota M, Yoshida H, Homma H, Iwasaki S, Matsubara S. A case of restless legs syndrome successfully treated with quetiapine. Sleep Biol Rhythms. 2006;4(2):193–5. https://doi.org/10.1111/j.1479-8425.2006.00216.x.CrossRef

16.

Ocak D, Kotan VO, Paltun SC, Aydemir MÇ. Is restless legs syndrome related with depression/anxiety disorders or medications used in these disorders? A cross-sectional, clinic-based study. Psychiatry and Clinical Psychopharmacology. 2019;29(4):832–9. https://doi.org/10.1080/24750573.2019.1673943.CrossRef

17.

Pinninti NR, Mago R, Townsend J, Doghramji K. Periodic restless legs syndrome associated with quetiapine use: a case report. J Clin Psychopharmacol. 2005;25(6):617–8. https://doi.org/10.1097/01.jcp.0000186870.75042.25.CrossRefPubMed

18.

Vohra A. Quetiapine induced restless legs syndrome: a series of four cases. Asian J Psychiatr. 2015;16:73–4. https://doi.org/10.1016/j.ajp.2015.05.045.CrossRefPubMed

19.

Buturak SV, Yazici K, Yazici AE, Tot S, Basterzi AD. Restless legs syndrome in an elderly patient induced by combined use of low dose quetiapine and citalopram. Bull Clin Psychopharmacol. 2016;22(3):271–4.CrossRef

20.

Rittmannsberger H, Werl R. Restless legs syndrome induced by quetiapine: report of seven cases and review of the literature. Int J Neuropsychopharmacol. 2013;16(6):1427–31. https://doi.org/10.1017/S1461145712001599.CrossRefPubMed

21.

Oliveira C, Dehanov S, Vieira C, Maia T. Restless legs syndrome induced by quetiapine: a case report and review of the literature. Eur Neuropsychopharmacol. 2019;29:S123–4. https://doi.org/10.1016/j.euroneuro.2019.09.205.CrossRef

22.

Kanamitsu K, Arakawa R, Sugiyama Y, Suhara T, Kusuhara H. Prediction of CNS occupancy of dopamine D2 receptor based on systemic exposure and in vitro experiments. Drug Metab Pharmacokinet. 2016;31(6):395–404. https://doi.org/10.1016/j.dmpk.2016.07.003.CrossRefPubMed

23.

Chernoloz O, El Mansari M, Blier P. Effects of sustained administration of quetiapine alone and in combination with a serotonin reuptake inhibitor on norepinephrine and serotonin transmission. Neuropsychopharmacol. 2012;37(7):1717–28. https://doi.org/10.1038/npp.2012.18.CrossRef

24.

Sato H, Ito C, Hiraoka K, Tashiro M, Shibuya K, Funaki Y, et al. Histamine H1 receptor occupancy by the new-generation antipsychotics olanzapine and quetiapine: a positron emission tomography study in healthy volunteers. Psychopharmacology. 2015;232(19):3497–505. https://doi.org/10.1007/s00213-015-4002-2.CrossRefPubMed

25.

Michopoulos I, Ferentinos P, Oulis P, Gournellis R. Restless legs syndrome associated with the combined use of quetiapine and venlafaxine. J Clin Psychopharmacol. 2014;34(1):159–61. https://doi.org/10.1097/JCP.0b013e3182a95af2.CrossRefPubMed

26.

Ravyn D, Ravyn V, Lowney R, Nasrallah HA. CYP450 Pharmacogenetic treatment strategies for antipsychotics: a review of the evidence. Schizophr Res. 2013;149(1–3):1–14. https://doi.org/10.1016/j.schres.2013.06.035.CrossRefPubMed

27.

Paulzer M, Schoretsanitis G, Hiemke C, Grunde G, Haen E, Augustin M. Reduced clearance of venlafaxine in a combined treatment with quetiapine. Prog Neuro-Psychopharmacol Biol Psychiatry. 2018;85:116–21. https://doi.org/10.1016/j.pnpbp.2018.04.014.CrossRef

28.

Bergemann N, Kopitz J, Kress KR, Frick A. Plasma amisulpride levels in schizophrenia or schizoaffective disorder. Eur Neuropsychopharmacol. 2004;14(3):245–50. https://doi.org/10.1016/j.euroneuro.2003.09.001.CrossRefPubMed

29.

Tison F, Crochard A, Leger D, Bouee S, Lainey E, El Hasnaoui A. Epidemiology of restless legs syndrome in French adults - a nationwide survey: the INSTANT study. Neurology. 2005;65(2):239–46. https://doi.org/10.1212/01.wnl.0000168910.48309.4a.CrossRefPubMed

30.

Holmes R, Tluk S, Metta V, Patel P, Rao R, Williams A, et al. Nature and variants of idiopathic restless legs syndrome: observations from 152 patients referred to secondary care in the UK. J Neural Transm (Vienna). 2007;114(7):929–34. https://doi.org/10.1007/s00702-006-0614-3.CrossRef

Title: Transitory restless arms syndrome in a patient with antipsychotics and antidepressants: a case report
Authors: Juan Chen
Na Meng
Bingrong Cao
Yinghua Ye
Ying Ou
Zhe Li
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Antidepressant Drugs
Antipsychotics
Restless Legs Syndrome
Antidepressant Drugs
Venlafaxine
Antipsychotics
Amisulpride
Quetiapine
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03433-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transitory restless arms syndrome in a patient with antipsychotics and antidepressants: a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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