ŞADİYE VİSAL BUTURAK, Duygu TİRYAKİ, Ersel DAĞ, Yakup TÜRKEL

Restless legs syndrome in a bipolar disorder patient treated with olanzapine: is there an association?

Bu olgu sunumunun amacı iki uçlu bozukluğu (İUB) olan bir hastada olanzapinin neden olduğu huzursuz bacaklar sendromu (HBS) olgusunu bildirmek ve İUB ile HBS arasındaki olası ilişkiye dikkat çekmektir. Bir kadın hastaya İUB karma atak tanısı konuldu. Hastanın kullanmakta olduğu uzun salınımlı valproik asid 1000 mg/gün tedavisine 10 mg/gün olanzapin eklendi. Olanzapin başlandıktan sonraki gün dinlenme sırasında hastanın bacaklarında kaşın- ma, ağrı ve karıncalanma hissi başladı. Hastaya olanzapine bağlı HBS tanısı konuldu. Olanzapin dozu kademeli olarak azaltıldı. Ancak 2.5 mg/gün dozunda belirtiler sürüyordu. Olanzapin kesildikten bir gün sonra HBS belirtileri düzeldi. HBS, dikkat eksikliği hiperaktivite bozukluğu (DEHB), depresif bozukluklar, migren gibi bazı psikiyatrik ve nörolojik bozukluklarla birlikte görülebilir. İUB ile hem migren, hem de DEHB arasında genetik ilişki olduğunu gösteren çalışmalar vardır. Sonuç olarak İUB ve HBS arasında bir ilişki olabilir. Bizim bilgimize göre İUB ve HBS arasındaki ilişki ile ilgili çalışma yoktur ve bu konu ile ilgili ileri araştırmalara gerek vardır. (Anadolu Psikiyatri Derg 2015; 16(4):301-303)

Olanzapinle tedavi edilen bir iki uçlu bozukluk hastasında huzursuz bacaklar sendromu: Bir ilişki var mı?

The aim of this case report is to report a case of restless legs syndrome (RLS) in a patient with bipolar disorder (BD) caused by olanzapine and to draw attention to possible relationship between BD and RLS. A female patient was diagnosed with mixed episode of BD. Olanzapine 10 mg/day was added to the extended release valproic acid 1000 mg/d treatment that the patient was using. In the next day after the beginning of olanzapine, itching, aching and tingling sensations begun in her legs at rest. She was diagnosed as RLS caused by olanzapine. Then the dose of olanzapine gradually reduced. But the symptoms were continuing at the dose of 2.5 mg/day. RLS symptoms disappeared in the next day after discontinuation of olanzapine. RLS has comorbidity with some psychiatric and neurologic disorders such as attention deficit/hyperactivity disorder (ADHD), depressive disorders, migraine. There are studies that showed genetic relationship between BD and both migraine and ADHD. As a result there might be an association between BD and RLS. These may account for the appearance of RLS with low dose olanzapine in this case. To our knowledge there are no studies about the association between BD and RLS and further research are needed on this subject. (Anatolian Journal of Psychiatry 2015; 16(4):301-303)

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