Rate of augmentation from dopamine agonists

[Mikatrap]

I have read several times here that DAs should eventually lead to augmentation in all cases. Is there a scientific reference that supports this statement? I have looked into the litterature, and found augmentation rate as low as a few percents and up to 70%, which is quite confusing.

[Joolsg]

Sadly, as patients fail to report augmentation via their local government reporting systems ( & as most patients and doctors do not even recognise augmentation) it is VASTLY underreported.As you say, some studies show low %, others show 7% cumulatively per annum.

What is CLEAR is that the longer the study, the higher the rates of Augmentation. So if you study a group for 1 year, rates will be low. Study that SAME group for 10 years and the rates will probably be 100%.

The doctors who specialise in RLS in the USA see thousands of patients a year. In the UK and Europe, doctors will only see one or two patients a year. Inevitably, the US doctors see more people with augmentation and realise the scale.

In the UK, a neurologist will see maybe 10 RLS patients a year and doesn't regularly follow up on them. So augmentation is often missed.

Look at the RLS-UK website. The recent August study of 3722 patients showed over 50% on DAs were showing signs of augmentation.

If a proper detailed study of EVERY patient in the UK taking DAs were carried out, I'd bet a million pounds that over 80% of those on a DA for more than 5 years will be suffering augmentation.

[Madlegs1]

All as Jools has pointed out very clearly.

Also, for reasons not yet studied, each person seems to have a different time scale for augmenting.

It could be that some people cycle medication more rapidly than others, or the dosage might affect timescale.

There isn't really any percentage for science to study this topic---- but someday we will get it!

[SueJohnson]

40% to 70% of people will eventually suffer augmentation on dopamine agonists per the Mayo Clinic Updated Algorithm on RLS and Dr Earley a RLS expert believes everyone will eventually suffer from augmentation.

I don't know of any studies but these are results from doctors who treat patients.

[karjbee]

yes I tend to believe Dr Earley on this. I think augmentation is vastly under reported. As a guess the information is not passed on for research. I have had augmentation with every DA they work for awhile then it happens. I had symptoms taking the whole dose of mirapex at Night. I decided to split it and take half in morning and the other at night. And increase the iron taken with Vitamin C. Also magnesium , B6, and D with K added. I have not had any symptoms for 10 months now. However I know I am on borrowed time, I would like to wean off it before it happens. I just attended the RLS Research Summit through the RLS foundation. Oh my gosh there is so much research happening and even so there is so much not known. I just can’t excuse doctors for not educating themselves on the disease. We all do our own research, at our levels. But we all don’t come at it with the same medical knowledge to under stand the biochemistry of it all. To me it would be so easy to study the literature, there is so much more available to them. Plus they have access to speak with any researcher or doctor about it. It’s just so unfortunate, but as a long time nurse very understandable.