RESTLESS LEGS SYNDROME
An epilepsy drug may prove effective at easing symptoms.
* THE QUESTION Can an epilepsy drug treat symptoms of restless legs syndrome, or RLS -- a sometimes-painful condition where the patient has an urge to move the legs that gets worse at night?
* PAST STUDIES have shown that drugs used to treat involuntary movements associated with Parkinson's disease can also treat RLS, but they have undesirable side effects such as nausea and long-term complications such as worsening of symptoms.
* THIS STUDY randomly assigned eight men and 16 women with RLS to receive either gabapentin (Neurontin), a drug used for epileptic seizures, or a placebo for six weeks. The treatments were switched for another six weeks. When the participants were taking gabapentin, they had, on average, fewer symptoms and moved their legs less often during sleep. Those with pain sensations showed the greatest benefits from the drug.
* WHO MAY BE AFFECTED BY THESE FINDINGS? People with RLS.
* CAVEATS Pfizer, the manufacturer of Neurontin, funded the study. In addition, the results need to be verified in more people and for a longer period.
* BOTTOM LINE People with restless legs syndrome may wish to consult their physician about treatment with gabapentin.
* FIND THIS STUDY Nov. 26 issue of Neurology; abstract online at www.neurology.org/current.shtml.
HRT and antioxidants do not prevent disease progression.
* THE QUESTION Do hormone replacement therapy (HRT) or antioxidant vitamins, which are often used to slow the progression of heart disease, actually do so?
* PAST STUDIES have produced conflicting answers to this question.
* THIS STUDY compared blocked arteries in 423 post-menopausal women randomly assigned to receive either estrogen plus progesterone or an HRT placebo each day and vitamin E plus vitamin C or vitamin placebos twice a day for about three years. Women who received HRT or antioxidants or both experienced more narrowing of arteries than those who received placebo treatments, but these differences were not statistically significant.
* WHO MAY BE AFFECTED BY THESE FINDINGS? Post-menopausal women with heart disease.
* CAVEATS Treatment groups may have had a different degree of blocked arteries at the beginning of the study. In addition, the results need to be verified in more women.
* BOTTOM LINE Post-menopausal women trying to retard progression of heart disease should not rely on HRT or antioxidants. They may wish to consult their physician about other treatments, such as cholesterol-lowering drugs. Women with poor diets may still wish to take recommended daily doses of vitamins C (75 milligrams) and E (30 IU) for other benefits, such as protection from cancer.
* FIND THIS STUDY Nov. 20 issue of the Journal of the American Medical Association; abstract online at http://jama.ama-assn.org/.
Secretin is no better than placebo for limiting symptoms.
* THE QUESTION Does the digestive hormone secretin affect the most visible symptoms of autism?
* PAST STUDIES have had conflicting results on the effectiveness of natural or synthetic secretin, a digestive hormone, in treating the language and behavioral symptoms of autism.
* THIS STUDY examined the effectiveness of porcine secretin and a synthetic form of the hormone in 85 children with autism. The researchers randomly assigned the children, who were between the ages of 3 and 12, to receive a single injection of either secretin or a placebo. Children in both groups showed improvements in their symptoms, but the treatment group did not benefit enough to show that secretin was effective.
* WHO MAY BE AFFECTED BY THESE FINDINGS? Children with autism.
* CAVEATS It is possible that repeated doses of secretin might produce different results. In addition, the study was not large enough to detect whether some subgroup of patients may respond to the treatment used in this case.
* BOTTOM LINE Parents of children with autism should not rely on secretin for relieving their child's symptoms. Instead, they may wish to use known effective treatments such as behavioral interventions and drugs that treat attention and hyperactivity problems.
* FIND THIS STUDY November issue of the Journal of the American Academy of Child and Adolescent Psychiatry; abstract online at www.jaacap.com/.
-- Haleh V. Samiei