@article {Winkelmane1520作者={约翰·韦尔温克曼主持和本杰明在制品和Jordana Zackon}, title ={剂量长期安全稳定,阿片类药物的功效不宁腿综合症患者在全国RLS阿片类药物注册},体积={100}={14},页面= {e1520——e1528} = {2023}, doi = {10.1212 / WNL。出版商0000000000206855}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标不宁腿综合症(RLS)是一种感觉神经障碍。首页低剂量的阿片类药物是耐火材料或增强RLS患者规定。长期安全、稳定剂量和疗效RLS的这些药物治疗仍不清楚。在这项研究中,我们报告2年期纵向数据样本RLS阿片类药物患者的社区。方法全国RLS阿片类药物注册表是一个观察个人服用处方阿片类药物组成的纵向研究诊断和确认RLS,大多数人经历的症状增强多巴胺受体激动剂。信息阿片类药物剂量,副作用,过去和当前伴随RLS治疗,RLS严重性,精神症状,阿片类药物滥用的风险因素是初始注册表项的收集和调查每6个月之后的搬运工。没有反馈或干预研究人员所提供的本地供应商。结果注册参与者(n = 448), 2年纵向数据大多是白色,女,年龄超过60岁,而且,在注册表项,一直对阿片类药物的中值1 {\ textendash} 3年平均吗啡毫克当量(MME) 38.4 (SD = 43.5)。没有改变RLS严重性在整个队列在2年随访期间观察到的。平均每日阿片类药物剂量变化从基线到2年0的居里夫人(四分位范围= 0 {\ textendash} 10)。 While 41.1\% of participants increased their dose during the follow-up period (median increase = 10 MME), 58.9\% decreased their dose or saw no change. Only 8\% and 4\% saw increases of \>25 MME and \>50 MME, respectively. Ninety-five percent of those who increased opioid dose \>25 or \>50 MME had one of the following features: switching opioids, discontinuation of nonopioid RLS treatment medications, at least mild insomnia at baseline, a history of depression, male sex, younger than 45 years, and opioid use for comorbid pain.Discussion Low-dose opioid medications continue to adequately control symptoms of refractory RLS over 2 years of follow-up in most of the participants. A minority of patients did see larger dose increases, which were invariably associated with a limited number of factors, most notably changes in opioid and nonopioid RLS medications and opioid use for a non-RLS condition. Continued longitudinal observations will provide insight into the long-term safety and efficacy of opioid treatment of severe, augmented RLS.Classification of Evidence This study provides Class IV evidence that opioid doses increase in roughly 40\% of patients, in most by small amounts, over a 2-year period when prescribed for adult refractory restless leg syndrome.GAD-7=generalized anxiety disorder-7 scale; IRLS=International Restless Legs Syndrome Study Group Severity Scale; ISI=insomnia severity index; MDD=major depressive disorder; MME=morphine milligram equivalent; PHQ-9=Patient Health Questionnaire; RLS=restless legs syndrome; RLSF=Restless Legs Syndrome Foundation}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/100/14/e1520}, eprint = {//www.ez-admanager.com/content/100/14/e1520.full.pdf}, journal = {Neurology} }