Table of Contents

2019 Month : June Volume : 8 Issue : 23 Page : 1816-1819

THE ROLE OF DAILY CO-CARBIDOPA THERAPY IN CHRONIC RESTLESS LEG SYNDROME AND ITS ASSOCIATION WITH AUGMENTATION IN A STUDY IN TERTIARY CARE CENTRE IN SOUTH INDIA.

Mohanakkannan S1, Sowmini P. R2, Sakthi Velayutham3, Malcolm Jeyaraj4, Mugundhan Krishnan5, Arunan S6

Corresponding Author:
Dr. Sowmini P. R,
Assistant Professor,
Department of Neurology,
Stanley Medical College and Hospital,
Chennai, Tamilnadu, India.
E-mail: drprsowmini@yahoo.co.in

ABSTRACT

BACKGROUND

Co-carbidopa was the first drug introduced for restless leg syndrome. But its use is not advocated much due to increased incidence of augmentation amongst the users. The first dopaminergic drug that was used in the treatment of RLS was co-carbidopa. However, it was noted in subsequent studies that there was a decline in the efficacy of co-carbidopa and there was an increase in the frequency, duration and intensity of symptoms with increased duration of co-carbidopa therapy which was termed as "augmentation". We wanted to define the role of co-carbidopa therapy in Chronic Restless Leg Syndrome and its association with augmentation.

METHODS

30 patients of chronic RLS were selected according to the IRLSSG criteria. They were treated with co-carbidopa. Their IRLSSG scores were monitored at baseline, 2 months and 6 months. Every month, the patients were monitored according to Max Planck Institute criteria for development of augmentation. If the patients develop augmentation, they were treated with Gabapentin. The IRLSSG scores were compared for treatment efficacy.

RESULTS

10 of 30 (33.3%) patients developed augmentation. The remaining 20 patients had statistically significant reduction in IRLSSG score at 2 months (p=0.003) and 6 months (p =0.009).

CONCLUSIONS

Co-carbidopa may be an effective therapy in chronic daily restless legs syndrome as suggested by the good response in our study. The incidence of augmentation amongst South Indian population may not be as high as the western literature. Restless legs syndrome can be easily mistaken for small fibre neuropathy of Diabetes Mellitus and subsequent treatment with tricyclic antidepressants may worsen their symptoms.

KEY WORDS

Restless Leg Syndrome, Augmentation, Carbidopa in RLS

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