I have restless legs syndrome attacks at night for which I take a small daily dose of pramipexole. But it makes me tired and pretty bad during the day. I am exhausted.
Dinah Prince, Caerleon, Gwent.
Restless Legs Syndrome (RLS) is a very uncomfortable feeling in the lower limbs that only movement resolves – hence the name.
The urge to constantly move your legs is worse at rest, but especially at night when it can be severe enough to disrupt sleep, which can also affect daytime well-being.
Although the cause of RLS is not entirely clear, we do know that there may be a genetic element, and some evidence suggests that it is related to the amount of dopamine, a chemical messenger in the brain that helps control muscle movement: dopamine levels naturally drop ‘in the evening. .
Pramipexole is one of the most commonly prescribed treatments for RLS – it belongs to a group of medicines called dopamine agonists, which work by mimicking the effects of dopamine.
The urge to constantly move your legs is worse at rest, but especially at night when it can be severe enough to disrupt sleep, which can also affect daytime well-being
Although they are effective in treating RLS, they can cause side effects such as drowsiness, fatigue, and nausea.
In your long letter you ask whether an alternative drug, pregabalin, might not be a better choice. Both pregabalin and a similar drug called gabapentin have been shown to be effective for RLS. Although dizziness and lightheadedness are also known side effects of these drugs, if you are interested in trying one of them, start with low doses, and I would suggest reporting this to your family doctor. (However, these drugs may not be suitable for people who are overweight, have severe depression, or have an unsteady gait.)
You may also need to replace iron if your blood levels of ferritin (a measure of how much iron is stored in your body) are below 75 ng/ml – low iron levels can interfere with dopamine activity in the brain.
Iron tablets or injections can restore ferritin levels and relieve symptoms of RLS, although it is likely that your doctor took this into account when making the diagnosis. I hope this helps.
My husband and I have been married for 51 years, but his mental memory has been declining lately. He misplaces things and needs simple instructions repeated several times. Our daughters shrug off my concerns about dementia and the GP only sees him when asked but insists he is fine.
given name and address.
From your description of the changes in your husband’s mental acuity, I suspect that he has mild cognitive impairment – a change in brain function, with memory loss being the most common symptom.
A GP can make an initial assessment using a standard questionnaire, the so-called mini-mental status survey. If his score is low, he may need to be referred for a brain scan and more detailed evaluation by a clinical psychologist.
But he may also need blood tests to check, for example, his thyroid function and vitamin B12 levels, as these are possible causes of cognitive decline. Another possibility is “masked” depression – a depressed state with no obvious mood swings or side effects from medications you take regularly.
From your description of the changes in your husband’s mental acuity, I suspect he has mild cognitive impairment – a change in brain function, with memory problems being the most common symptom
I suggest you organize a family reunion with your daughters to convey your concerns to your husband.
Provide examples of his mistakes: The goal is to allow him to talk about his own fears and at least accept that he needs to seek medical advice.
Explain that one in six people over 70 have mild cognitive impairment, but half will not develop dementia.
As I explained in a recent column on the topic, there is no cure for mild cognitive impairment, but some research suggests that regular exercise, a nutritious diet, and cognitive training hold promise.
I hope this approach will convince your husband of the need to see his GP.
Write to Dr. scramble
Write to Dr. Scurr to Good Health, Daily Mail, 9 Derry Street, London W8 5HY or email: drmartin@dailymail.co.uk – add contact details. DR Scurr cannot respond to personal correspondence. Answers should be taken in a general context. If you have health problems, contact your GP
In my eyes: Woe to the patients who cannot go online
My generation lived in a golden age of GPs and although it was not without its problems, I never thought there would come a time when medical care in the community would be so depleted.
When I started, a GP was contracted to see every patient over the age of 75 once a month. The health visitor before the practice would also regularly keep an eye on the infirm and elderly.
Both services have been phased out, and what’s worse, the advent of technology (email and video calling) has failed even more for those who can’t use it.
A whole part of our population has been thrown to the lions to eat. Who cares about widowers, frail elderly people who are not online, can’t use a smart phone, or don’t have family to fight for them?
Every practice must be forced to meet their needs – and this includes reintroducing regular health checks. lives depend on it.
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
