Neurology appointment

[Rangers52]

Hi everyone I've an appointment on the 4th September with a neurologist in Edinburgh his name is Dr David P Breen.Does anyone know of him?

[ChrisColumbus]

Only his online profile. Principal interest seems to be Parkinsons but also movement disorders in general:

research.ed.ac.uk/en/person...

[Joolsg]

Remember that in the UK, even neurological have not been taught anything about RLS, so make sure you go to the appointment armed with the basic info on latest research and treatment.Doctors should know the following:

Q

1. Take full iron panel blood tests to ensure serum ferritin is above 100ųg/L, preferably 200ųg/L & start iron therapy if not.

2. Review and safely replace ALL trigger meds that cause/worsen RLS ( anti depressants, sedating anti histamines, statins, beta blockers, PPI gastric meds).

3. If 1 & 2 don't work, start patient on pregabalin or gabapentin AT NIGHT only ( daytime dosing is for pain , not RLS).

4. If 3 doesn't work after 2/3 months, start a long half life opioid ( Buprenorphine or methadone).

Dopamine Agonists ( Ropinirole,Pramipexole and Neupro patch) are not prescribed by experts and the American Academy of Sleep Medicine has relegated them to 'end of life scenarios'.

So. If Dr Breen suggests a dopamine agonist, explain that he is behind the latest research and treatment and that you would like him to follow steps 1 to 4 above.

RLS-UK has printable help sheets on DA withdrawal and Iron therapy, so you could show him those.

Good luck.

[SueJohnson]

He specializes in Parkinson's. I don't see anything in his research or interests on RLS. Don't let him prescribe levodopa which is a DA. Since you want buprenorphine I would print out the section on opioids from the Mayo Algorithm and take it with you.

[Madlegs1]

If Parkinson's is his primary interest, he is likely hardwired for prescribing DAs.

This will be a great opportunity to educate him.😎💚