Dipyridamole: How a Drug for Blood Clots Became a New Treatment for Restless Legs Syndrome (RLS)

Dipyridamole is an old drug that is a new treatment for restless legs syndrome (RLS). How does a drug used to prevent blood clots work for improving symptoms of RLS? ‪@andyberkowskimd‬ of ReLACS Health tells the story of dipyridamole and RLS in this video
Among the following topics discussed:
Where do we commonly see dipyridamole used in the medical field?
The role of adenosine in RLS
The landmark 2021 randomized, clinical trial of dipyridamole in RLS (see reference below)
Dosing of the medication for RLS
Benefit of lower drug interactions
Potential adverse effects of dipyridamole
Caution in those taking anti-platelet or anticoagulant medications
- ‪@andyberkowskimd‬ and the personal experience prescribing this medication in RLS
Is this drug effective for severe RLS or augmentation?
When to consider using dipyridamole after first-line treatments
Here is the 2021 clinical trial of dipyridamole by Dr. Garcia-Borreguero and colleagues in Spain:
movementdisord...
In case you, or more importantly, your doctor remains unaware of the harms of dopamine agonists for RLS treatment, the 2024 Clinical Practice Guidelines by the American Academy of Sleep Medicine do NOT recommend treatment with these medications with only rare exception.
For additional information on why dopamine agonists are bad for RLS, read this blog post:
www.relacsheal...
For the many who are stuck on dopamine agonists like pramipexole (Mirapex®), ropinirole (Requip®), or rotigotine (Neupro®) and find their RLS get worse over months or years, augmentation is a serious problem. Those with this phenomenon should taper off the medication under medical supervision and this video gives guidance on how this is done more smoothly:
• How to Taper off Dopam...
What are first-line treatments for RLS now?
This video explains the importance of increasing iron levels before any drug is ever prescribed:
• Iron Levels for Restle...
Gabapentin and gabapentin enacarbil (Horizant®) are consensus first-line medications for RLS. This video illustrates the similarities and differences:
• Gabapentin Versus Hori...
Pregabalin (Lyrica®) is a cousin of the gabapentinoids and is another first-line consensus treatment for RLS. How does it work?
• Lyrica for Restless Le...
Opioid medications are an important treatment for moderate to severe RLS when first-line options have not been effective.
Buprenorphine may be the best opioid to use for RLS. This video explains why:
• Buprenorphine for Rest...
These videos are for general medical information only, but for those who live in or near Michigan, Ohio, or Florida, you can hire ‪@andyberkowskimd‬ ReLACS Health as your personal RLS manager. He can discuss if you are a candidate for dipyridamole and assist in all aspects of your sleep health. Go to www.relacsheal... to schedule your consultation now.

[@monicamestas7566]

Love your puppy! Nice addition. I kept trying to look over your shoulder LOL

[@monicamestas7566]

I saw you are one of the speakers at the April 6 RLS Research Virtual Summit presented by the RLS Foundation. I'd love to tune in but don't think I can swing the $75 registration fee. I'm sure there will be a ton of terrific information. Maybe you can recap here later :)

[@andyberkowskimd]

The presentation will be on research of buprenorphine in the treatment of severe RLS. There will be full publication we can put out hopefully within the year, but we published an abstract last year: academic.oup.com/sleep/article-abstract/46/10/zsad230/7261378?redirectedFrom=fulltext&login=true

[@meneerjansen00]

Is it less addictive than Pregabalin (Lyrica)?

[@andyberkowskimd]

Dipyridamole is not a controlled substance and is not abused. Pregabalin is a schedule V controlled substance so some abuse potential, more in conjunction with other drugs of abuse but very low risk overall.

[@WideBody736]

Yes it is less addictive with a lot less side effects. Small headache, but it goes away over time.

[@behappy3398]

coffee makes many people able to go back to sleep including me.

[@AprilTeniente-eu1mj]

I had a little blood clot in my right leg when I didn’t get up or walk because of the restless leg syndrome, but my mom took me and my leg to the hospital and the doctors said that I had a blood clot in my right leg, so I will exercise or maybe safely sit down for two weeks and relax and elevate my right leg.

[@andyberkowskimd]

RLS is not related to blood clots as it is occurring inside the brain and not the legs or blood vessels in the legs. Dipyridamole is primarily used to prevent blood clots, but it turns out that the chemical penetrates the brain and has a positive impact on RLS.

[@AprilTeniente-eu1mj]

@@andyberkowskimd Well, I know. That blood clot is different from Restless Leg Syndrome, which is caused by the things

[@garystubblefield5742]

I’m going to ask my pcp if she will look at your videos

[@David-gi8ei]

Use a red kratom. Not as dangerous.

[@Galenalicia11]

So your asking people who suffered for mutipal decades, and finaly found relief on small dose of tramadol, to try this on limited sucess?

[@andyberkowskimd]

www.relacshealth.com/blog/is-tramadol-for-restless-legs-syndrome-treatment-a-wolf-in-sheeps-clothing

[@sunnydee5998]

I thought It was caused by a B1 deficiency? And you need B1 vitamins???

[@andyberkowskimd]

There is no research showing a link with RLS and thiamine. RLS is mostly associated with iron deficiency, though studies of vitamin C and vitamin E have had some success in those with chronic kidney disease and RLS.

[@charliejb1747]

@Galenalicia11 Not all drugs work in the same way for everyone. Tramadol can and does, exacerbate restless legs in many people.

[@monicamestas7566]

I believe he's putting it out there as a possible treatment for some people who are not getting sufficient relief from other treatments.

[@gregorymailman9733]

Tramadol does work low dosed just hard to get from doctors..gna start growing opium

[@andyberkowskimd]

Tramadol has opioid properties that help with RLS but also some other neurological chemicals (e.g. serotonin) that may worsen RLS with time: www.relacshealth.com/blog/is-tramadol-for-restless-legs-syndrome-treatment-a-wolf-in-sheeps-clothing