Re: RLS/Drugs/Dopamine

[Guest guest]

Muriel wrote:

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>

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> I was recently at a non-smokers retreat to stop smoking and we watched this

video which said that when we become addicted to nicotine, alchol, drugs, it

effects the level of doparmine in our brain.

> This made me wonder about the effects of Permax which works on the levels of

dopermaine. Since I was once addicted to alchol, and also nicotine, could

Permax be harmful to me or to anyone who has been

> an addict. I think Sinemet works on the dopermain levels also, so that might

also be harmful. Over the last week I have tried a nightime dose of permax, 1

Kolonopin and a darvocet, if needed.

> I have been able to sleep. However, I have heard that Kolonopin is highly

addictive so I don't take it all the time. I do the the same with the darvocet,

I take a week holiday from that also,but not

> together. I also spent a lot of time trying out alternative therapies

> including yoga and acupuncture. I am planning to find out about a Chinese herb

mixture which is suppose to work for restless legs. As

> soon as I find it and try it, I will give everyone a report. Are there any

paticular foods that are bad for rls besides caffiene.?

>

Muriel

Please do not think that I am being critical of you for collecting facts

about RLS. I think that you are to be commended for thinking about the

effects of drugs on your body. But, " facts " are a two-edged sword. They

must be put into context to be useful and you must know and trust the

source of " facts. " You don't know me or anything about me other than I

am a physician who has RLS. I am not asking you to accept anything that

I say as the gospel. But since you asked me, here we go.

Nicotine derived from smoking tobacco causes an elevation of brain

dopamine in animals. I know of no studies in humans correlating dopamine

levels and long-term smoking. Studies in RLS patients have shown no

worsening of RLS with the use of cigarettes. Many doctors say that RLS

patients should avoid cigarettes because it aggravates RLS. I have no

idea where they are getting that information. Cocaine supposedly causes

an increase in brain dopamine and that is what gives the feeling of

euphoria with cocaine. Whether long term users of cocaine have

meaningful changes in their brain dopamine is unknown to me. Alcohol

causes an elevation of brain dopamine on a short-term basis but causes a

decrease in dopamine on a chronic basis in animals.

Whether any of the above information has any clinical meaning, I don't

know. They are just isolated pieces of a very complex puzzle, for

example: A drink of alcohol makes RLS worse in many people. But it is

supposed to elevate brain dopamine and the current thought is that RLS

should respond to elevating dopamine. No clinical correlation. Some

doctors say smoking makes RLS worse, some patients say it helps their

RLS, and smoking raises dopamine levels. No clinical correlation. The

subject of alcoholism and RLS keeps popping up but really hasn't been

studied, just anecdotes. Which came first? Was the RLS there all the

time but hadn't become severe enough to notice? Nobody knows.

Permax does not alter levels of dopamine. It activates dopamine

receptors in the brain and tricks the brain to think that increased

dopamine is present. Sinemet is changed to dopamine in the brain and

acts just natural dopamine. Are previous " addicts " at risk when they

take these drugs? No more so than anybody else. No one knows all of the

long term effects of taking these drugs (or any other drug). No damage

has been demonstrated over a 5-10 year period that Sinemet has been used

for RLS. No studies have been performed on " addicts. "

The terms " addicts " and " addiction " must be carefully defined to avoid

confusion with terms like habituated, physical dependence, physiologic

dependence and substance abuse. The terminology used by the National

Institute of Drug Abuse defines " addiction " as uncontrollable,

compulsive drug-seeking and use. Klonopin and the other benzodiazepines

typically do not cause " addiction " as defined above. You may develop

tolerance to them and show physical signs of withdrawal, but not

uncontrollable, compulsive drug-seeking and use. Withdrawal reactions

may be very severe, but that alone doesn't make you an addict. While

tolerance and withdrawal reactions do occur with benzodiazepines, they

are much more common when used for recreational purposes. (Please, no

flaming from members who have had reactions. I said that they do occur.)

As for foods, there is disagreement about the effects of caffeine. Many

doctors say avoid it like the plague while many patients say it helps or

does nothing for their RLS. Ice cream has acquired a bad reputation in

some patients with RLS. Whether or not this is real, I don't know. I

know of no other foods that universally aggravate RLS, nor do I know of

any foods that help RLS.

If I have left anything out, please ask.

Happy holidays

Dr. Levin