HISTAMINE AND THE RESTLESS LEGS SYNDROME

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 临床经验表明，镇静抗组胺药和苯海拉明尤其会加重RLS。这些调查人员此前曾评估过 苯海拉明对控制良好的RLS患者的SIT试验（RLS症状激发试验）的影响。SIT测试显示，苯海拉明产生了戏剧性和显着恶化的RLS，远远大于劳拉西泮（另一种镇静药物）或安慰剂。目前尚不清楚苯海拉明对RLS的不良反应是由于对疾病的直接影响还是通过与多巴胺能药物的相互作用。除了多巴胺能药物外，RLS还可以用阿片类药物治疗。这些研究者试图评价苯海拉明对阿片类药物治疗但不接受多巴胺能治疗的RLS患者的反应。这些研究将导致更大和更全面的临床试验，以评估治疗和未治疗患者的抗组胺反应，以及确定阿片类药物和多巴胺激动剂对组胺反应的相对影响。 因此，主要假设是RLS中的抗组胺作用是由于基础疾病状态而发生的，而不是继发于多巴胺能药物的改变。因此，这些研究者预计接受阿片类药物RLS治疗的患者将表现出与接受多巴胺能治疗的患者相似的苯海拉明反应。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Clinical experience has indicated that sedating anti-histamines and diphenhydramine in particular exacerbated RLS. These investigators have previously evaluated the effect of diphenhydramine on the SIT test (a provocative test for RLS symptoms) in well controlled RLS patients. The SIT test showed diphenhydramine produced dramatic and marked worsening of RLS, much greater than lorazepam (another sedating medication) or placebo. It is unclear whether the adverse effect of diphenhydramine on RLS was due to direct effect on the disease or through interaction with dopaminergic medications. In addition to dopaminergic medications, RLS is also treated with opioids. These investigators seek to evaluate the diphenhydramine response for patients on opioids but not dopaminergic treatment for their RLS. These studies will lead to larger and more comprehensive clinical trials to evaluate the anti-histamine response for both treated and untreated patients as well as determine the relative affects of opioids and dopamine agonists on the histamine reaction. Thus, the primary hypothesis being addressed is that the anti-histamine effects in RLS occur because of underlying disease state and are not secondary to alteration of dopaminergic medications. Therefore, these investigators expect that patients treated with opioids for RLS treatment will demonstrate a similar response to diphenhydramine as the patients on dopaminergic treatment.