Effects of gabapentin enacarbil on restless legs syndrome and leg pain in dementia with Lewy bodies.

Abstract

Restless legs syndrome (RLS) is a common neurological disorder. Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease. Both RLS and DLB can be effectively treated by dopaminergic medications, suggesting the role of dopamine dysfunction in the pathogenesis of both diseases. Here, I report on a Japanese woman with probable DLB and RLS who was treated with gabapentin enacarbil, a non-dopaminergic agent. Because a dopamine agonist, a first-line therapy for moderate to severe RLS, caused the occurrence of metamorphopsia, an alternative treatment of gabapentin enacarbil was used; this treatment improved the patient's RLS without worsening her psychiatric symptoms. An alternative treatment is desirable for DLB patients with RLS because they often experience intolerable side-effects with a dopamine agonist, especially visual hallucinations. Administering gabapentin enacarbil also improved the continuous leg pain that occurred in conjunction with the development of RLS. Although the neurobiological mechanism in the development of pain remains unclear, a range of non-dopaminergic structures likely mediated pain processing in DLB in the present case based on neuropharmacological results. This is the first report reporting the effects of gabapentin enacarbil for RLS and leg pain in a DLB patient with psychiatric symptoms.

• Authors: Hiroshige Fujishiro
• Journal: Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society (Psychogeriatrics) Vol. 14 Issue 2 Pg. 132-4 (Jun 2014) ISSN: 1479-8301 [Electronic] England
• PMID: 24528871 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2014 The Author. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Chemical References

• 1-(((alpha-isobutanoyloxyethoxy)carbonyl)aminomethyl)-1-cyclohexaneacetic acid
• Carbamates
• Dopamine Agonists
• gamma-Aminobutyric Acid

Topics

• Aged
• Carbamates
• Dopamine Agonists (therapeutic use)
• Female
• Hallucinations (etiology, psychology)
• Humans
• Japan
• Leg
• Lewy Body Disease (diagnosis, drug therapy, psychology)
• Magnetic Resonance Imaging
• Pain (drug therapy)
• Restless Legs Syndrome (drug therapy)
• Treatment Outcome
• gamma-Aminobutyric Acid (analogs & derivatives)