Pramipexole Approved for Restless Legs Syndrome: Dopamine Agonists Were Already Considered First-Line Treatment

By Mechcatie, Elizabeth | Clinical Psychiatry News, January 2007 | Go to article overview

Pramipexole Approved for Restless Legs Syndrome: Dopamine Agonists Were Already Considered First-Line Treatment


Mechcatie, Elizabeth, Clinical Psychiatry News


While misdiagnosis of restless legs syndrome remains common, the Food and Drug Administration has increased the agents available to treat this movement disorder by approving the dopamine agonist pramipexole for moderate to severe cases.

Pramipexole is the second drug and the second dopamine agonist to be approved for this condition. The first was ropinirole (Requip), another dopamine agonist approved last year for restless legs syndrome (RLS), which affects as many as 3% of the population.

Dopamine agonists have been considered first-line treatments for RLS by expert consensus panels before they were approved, according to Dr. John Winkelman, who is medical director of the sleep health center at Brigham and Women's Hospital, and Harvard Medical School in Boston.

Although it will take more time for recognition of RLS to improve, "the good news is that the treatments are so effective and generally so well tolerated, it is very gratifying to treat," and treatment typically produces a rapid response, Dr. Winkelman said.

In his experience, it is "the unusual patient who does not have some response to one of the dopamine agonists, and you need to go back and reassess the diagnosis" in patients who have no response.

Both pramipexole, marketed as Mirapex by Boehringer Ingelheim, and ropinirole, marketed as Requip, have been available for almost 10 years, since they were approved for Parkinson's disease. (Dr. Winkelman is a consultant to Boehringer Ingelheim and to ropinirole manufacturer GlaxoSmithKline, as well as other companies that manufacture products for insomnia and other sleep disorders.)

Pramipexole was significantly more effective than placebo in four randomized, double-blind, 3- to 12-week studies of about 1,000 patients with moderate to severe RLS, which evaluated the effect of treatment on a scale based on patient-reported symptoms and a Clinical Global Impressions scale.

Dr. Winkelman was the lead author of one study of 344 patients, published in September, which found that at 12 weeks, the patients on three fixed doses of pramipexole had significantly greater improvements from baseline than those on placebo in a scale that represented patient rating of symptom severity, which covers different aspects of RLS, such as effects on sleep and next-day functioning.

In addition, 70%-75% of patients on the three doses of pramipexole studied were rated as "very much improved" or "much improved" on a clinician rating scale, compared with 51% of those on placebo, a significant difference (Neurology 2006;67:1034-9). …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Pramipexole Approved for Restless Legs Syndrome: Dopamine Agonists Were Already Considered First-Line Treatment
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.