Restless legs syndrome in a bipolar disorder patient treated with olanzapine: is there an association?

Abstract

The aim of this case report is to report a case of restless legs syndrome (RLS) in a patient with bipolar disorder (BD) caused by olanzapine and to draw attention to possible relationship between BD and RLS. A female patient was diagnosed with mixed episode of BD. Olanzapine 10 mg/day was added to the extended release valproic acid 1000 mg/d treatment that the patient was using. In the next day after the beginning of olanzapine, itching, aching and tingling sensations begun in her legs at rest. She was diagnosed as RLS caused by olanzapine. Then the dose of olanzapine gradually reduced. But the symptoms were continuing at the dose of 2.5 mg/day. RLS symptoms disappeared in the next day after discontinuation of olanzapine. RLS has comorbidity with some psychiatric and neurologic disorders such as attention deficit/hyperactivity disorder (ADHD), depressive disorders, migraine. There are studies that showed genetic relationship between BD and both migraine and ADHD. As a result there might be an association between BD and RLS. These may account for the appearance of RLS with low dose olanzapine in this case. To our knowledge there are no studies about the association between BD and RLS and further research are needed on this subject.