A Wake-up Call for Dopamine Agonists from Dr Berkowski

[ChrisColumbus]

A follow up to SLEEP 2024 this piece, published last week, adds to the warnings about DA use and confirms that "the former first-line DAs have now been downgraded to NOT recommended":

opmed.doximity.com/articles...

[Joolsg]

Fantastic News.Let's hope this is the beginning of the end.

Now, just to educate UK doctors.

[Flora-Rose]

I was pleased to read at the end of the SLEEP 24 paper about the ‘new kid on the block’ - the perineal nerve stimulation cuff. What are your thoughts?

[ChrisColumbus in reply to Flora-Rose]

Peroneal nerve stimulation - whether electrical stimulation cuff by the expensive, currently limited availability US only, prescription only Noctrix Nidra TOMAC; or by percussion massager (various devices) or vibration stimulation cuff (Therapulse) - does seem promising.

As Dr Berkowski writes, the Nidra has been shown "able to reduce RLS drug treatment dose in many subjects" - but is that enough at the current $7500? It's surely only "cost effective" in the context of sky-high US medical treatment costs (and hopefully largely covered by their private insurance...)

The price would have to come down very considerably to be acceptable in the UK market. And I'd still really like to see a truly independent and properly conducted effectiveness trial comparing the Nidra with the so-much-cheaper Therapulse. I can imagine that electrical stimulation would be more effective than vibration, but I'd like to see that proven!

[Elisse3 in reply to ChrisColumbus]

I certainly agree with you on the electrical stimulation would be better than the vibration of the therapulse IF the electrical stimulation means you can reduce meds i still needed to take my usual med doses with the therapulse or would that mean a reduction of meds on how severe ones RLS is

[Jumpey]

Good article. 👍

[DicCarlson]

This is the article to print and bring to uninformed health care providers.

[amrob123]

A great find ChrisColumbus 👏

[violetta254]

I had conversation with the manufacturers of Nidra and it is only available in a couple states so far including CA and MA. They will expand based on neurologist input to other states by next year. But call them if you are interested. They can give you more information. Just google Nidra.

[ChrisColumbus in reply to violetta254]

That's helpful for US members, thanks. Flora-Rose who raised this above, and Elisse3 and I who responded, are all in the UK so while we're interested we're not holding our breath!

BTW, agree entirely on statins and cholesterol: Justin Smith's 'Statin Nation' is well worth a read:

archive.org/details/statinn...

[SueJohnson in reply to violetta254]

It's also available in Ohio and Maryland is next.