donohue 12.4

Be still, my restless legs

Dear Dr. Donohue:A while back, I remember, you wrote something about painful legs at nighttime. It was interesting, but I threw the paper out. Now it’s more interesting. I have it. Something crawls under the skin of my legs and drives me crazy until I get up and walk. What is this? How do you treat it? — L.P.

Quite a large number of people struggle with restless leg syndrome. It’s an intensely disagreeable sensation that surges through the legs when people are sitting quietly or, more often, when they go to bed. Many describe it as you do — a feeling that something is crawling in the legs. Walking subdues the sensation.

Why it happens is anyone’s guess. A few people have concomitant illnesses, such as iron-deficiency anemia, diabetes or rheumatoid arthritis. The majority have no associated illness. It just happens.

Massaging the legs before going to bed can quiet restless legs for some. A warm bath before bed helps others. Forgoing caffeine and alcohol often diminishes restless leg discomfort.

Your doctor can prescribe medicines that have a respected niche in treatment. Sinemet and Mirapex — Parkinson’s disease drugs — are effective medicines for a substantial number of patients. (Restless leg syndrome is not related to Parkinson’s disease, nor does it become Parkinson’s disease.) Klonopin and Neurontin — seizure-control medicines — are two other agents that can quiet restless legs.

Do you want an effective prescription? Call the Restless Leg Syndrome Foundation: (877) 463-6757. If Canadian readers cannot reach the foundation by phone, they can write to it at: 819 W. 2nd St. SW, Rochester, MN 55902. The foundation keeps its members abreast of any new developments in the treatment of this common syndrome.

Dear Dr. Donohue: My mother has been diagnosed with Alzheimer’s disease. She is 78. She was taking Aricept but had to stop. It seemed to be causing more problems with her illness.

I read your column about niacin helping. Is that true?

Why the abrasive manner and anger of patients? Do those changes come with the illness? — J.D.

Niacin for Alzheimer’s disease does not ring a bell with me. I can’t remember writing about it or reading that it helps.

Three medicines restore brain levels of acetylcholine for Alzheimer’s patients. Acetylcholine is a brain chemical that delivers messages from one brain cell to the next. In Alzheimer’s disease, it is in short supply. Those medicines are Cognex (tacrine), Aricept (donepezil) and Exelon (rivastigmine). They are far from being wonder drugs, but can slow the downward mental spiral for some patients.

Eldepryl, a drug for Parkinson’s disease, is often given a try for Alzheimer’s. Some trumpet the effectiveness of vitamin E.

Personality changes are part of the illness. A patient can become cranky, suspicious, insulting or bereft of emotions, along with having the Alzheimer’s memory deficit.

The Alzheimer’s report sheds light on the illness and its treatment. Readers can obtain a copy by writing: Dr. Donohue — No. 47, Box 536475, Orlando, FL 32853-6475. Enclose a self-addressed, stamped (55 cents), No. 10 envelope and $3. Please allow six weeks for delivery.