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1033 – Restless Legs Syndrome Induced By The Combined Use Of Quetiapine And Venlafaxine

Published online by Cambridge University Press:  15 April 2020

I. Michopoulos ,
R. Gournellis ,
P. Ferentinos ,
A. Douzenis ,
D. Tsaklakidou ,
A. Kaparoudaki ,
M. Papadopoulou ,
C. Papazahos  and
I. Liappas
I. Michopoulos
Affiliation:
2nd Department of Psychiatry, Attikon Hospital, Medical School, University of Athens
R. Gournellis
Affiliation:
2nd Department of Psychiatry, Attikon Hospital, Medical School, University of Athens
P. Ferentinos
Affiliation:
2nd Department of Psychiatry, Attikon Hospital, Medical School, University of Athens
A. Douzenis
Affiliation:
2nd Department of Psychiatry, Attikon Hospital, Medical School, University of Athens
D. Tsaklakidou
Affiliation:
2nd Department of Psychiatry, Attikon Hospital, Medical School, University of Athens
A. Kaparoudaki
Affiliation:
Center of Mental Health
M. Papadopoulou
Affiliation:
Department of Neurophysiology, Ygeias Melathron, Athens, Greece
C. Papazahos
Affiliation:
2nd Department of Psychiatry, Attikon Hospital, Medical School, University of Athens
I. Liappas
Affiliation:
2nd Department of Psychiatry, Attikon Hospital, Medical School, University of Athens

Abstract

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Introduction

Restless legs syndrome (RLS) is a sensorimotor disorder characterized of an urge to move the legs during periods of rest or inactivity, such as lying or sitting.

Objectives

Drug-induced RLS, still remains an under- or misdiagnosed condition.

Aims

We present a case of a female patient, who received a combination of low dose of quetiapine in addition to venlafaxine and manifested RLS.

Methods

Our patient was admitted because of a mixed episode of bipolar II disorder. At admission she was under valproic (1.5gr/QD, plasma levels: 79mg/litre), topiramate (100mg/QD) and venlafaxine (300mg/BID). Quetiapine 150 mg/QD was started at bed time and within 48 hours the patient showed RLS. The physical, neurological and laboratory examination was normal.

Results

The tapering of venlafaxine resulted in the elimination of RLS within 48 hours. After discharge the patient remained in a normothymic state, without RLS, taking valproate 1,5gr/QD, topiramate 100mg/QD and quetiapine 150mg/QD. After 6 months, because of depression, quetiapine was reduced to 100mg/QD and venlafaxine 75mh/QD was added. The previously described RLS symptoms emerged again within 48 hours. This time the tapering of quetiapine and its substitution by olanzapine 10 mg/QD resulted in a prompt and complete elimination of RLS symptoms.

Conclusions

Neither quetiapine alone, nor venlafaxine alone induced RLS to our patient. Clinicians should not overlook the possibility a RLS to be induced by quetiapine-vanlafaxine combination. The removal of one of the two drugs might be beneficial in the RLS's successful treatment.

Type
Abstract
Information
European Psychiatry , Volume 28 , Issue S1: Abstracts of the 21th European Congress of Psychiatry , 2013 , 28-E447
Copyright
Copyright © European Psychiatric Association 2013
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