HISTAMINE AND THE RESTLESS LEGS SYNDROME

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 临床经验表明，镇静、抗组胺药物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SIT试验(RLS症状的刺激试验)的影响。SIT测试显示，苯海拉明导致RLS显著恶化，远远超过劳拉西潘(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作用，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。这些研究人员试图评估服用阿片类药物的患者对苯海拉明的反应，而不是对他们的RLS进行多巴胺能治疗。这些研究将导致进行更大规模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，并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，提出的主要假设是RLS中的抗组胺效应是由于潜在的疾病状态而发生的，而不是次要于多巴胺能药物的改变。因此，这些研究人员预计，接受阿片类药物治疗的RLS患者将表现出与接受多巴胺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.