70° L/RAIN, Leg problems keeping you up at night?
Last Modified: Tuesday, April 15, 2008 at 9:31 a.m.
Q: I used to take quinine sulfate for nighttime leg cramps. I stopped because I didn’t think it was really helping.
A: Unfortunately, I’m not convinced that any medication, including quinine, is effective for nighttime (nocturnal) leg cramps. Although nighttime leg cramps are common, the cause is unknown. Besides aging, they are associated with flat feet, a sedentary lifestyle, dehydration and diabetes.
Options for treatment include: stretching; regular exercise; drinking plenty of fluids, especially around the time of exercise; applying heat (before or just after a cramp); and changing footwear, including using arch supports and good cushioning. Although unproven, a number of medications are often tried: quinine; muscle relaxants, such as cyclobenzaprine; diphenhydramine (Benadryl and many others); Verapamil; and Gabapentin.
The U.S. Food and Drug Administration took action in late 2006 to limit the use of prescription quinine so that it is used only as a treatment for malaria. That’s because studies suggest it does little to improve night cramps and it has some serious potential side effects, including an unstable heart rhythm, low blood counts and allergic reactions.
Q: I have restless legs, especially at night. My doctor prescribed clonazepam (Klonopin). It has not helped yet.
A: Restless legs syndrome is a relatively common condition marked by a bothersome urge to move the legs while resting. Stretching or other movements of the legs can relieve this urge but only temporarily. Stretching before bed and avoiding alcohol, nicotine and caffeine may be helpful. Yoga, homeopathy and acupuncture are of uncertain benefit.
While a number of medications may be helpful, only one is FDA-approved: ropinirole (Requip) was approved in 2005 for moderate to severe symptoms of restless leg syndrome. Other medications that may help include: Pramipexole, a medicine that works in a similar way as ropinirole; Clonazepam (Klonopin), triazolam (Halcion), zolpidem (Ambien) or related sedatives; Levodopa/carbidopa (Sinemet); Gabapentin (Neurontin); Opiods, such as codeine or propoxyphene (Darvon), though generally as an option only if other medicines have failed. Combinations of one or more of these medicines may be needed. The effects of clonazepam can generally be assessed within a few days of starting the medication. If you’ve been taking it for a week or two without benefit, talk to your doctor about adjusting the dose or considering another treatment option.
Today’s Medicine Cabinet was written by Robert H. Shmerling, M.D., an associate physician at Beth Israel Deaconess Medical Center, Boston, Mass. The Medicine Cabinet is distributed by Tribune Media Services Inc. and published Tuesdays in the TimesDaily. For additional consumer health information, visit health.harvard.edu.
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April 24, 2008 11:27:34 am
RE: http://www.timesdaily.com/apps/pbcs.dll/article?AID=/20.../NEWS/794515598/1004
I have helped several friends and family to stop nocturnal leg movement by telling them to take Magnesium supplements. Per the studies and teachings of the late Adelle Davis, this is but one of the problems resulting from Magnesium deficiency. Magnesium should be taken in combination with calcium, in the ratio of approximately 2 parts Calcium to 1 part Magnesium, such as 1000 mg Calcium to 500 mg Magnesium. The calcium should be in a highly absorbable form, such as a gluconate, ascorbate, citrate, etc. (not Calcium oxide or Calcium carbonate). For my friends and family, this has been an inexpensive easy remedy for a common syndrome.
April 24, 2008 11:34:38 am
Thanks virgo92, I have family members who would be willing to give this a try.
April 24, 2008 11:52:37 am
I have also heard of simply stretching before bed time can make the "tingling" or "pain" manageable.
You might look into recommended stretching exercised from a Physical Therapist. I have this funky lower back pain sometimes that causes my back and legs to tingle. Instead of popping pills, I stretch a little. It goes away instantly.
April 24, 2008 12:10:36 pm
Are you Robert H. Shmerling MD ? or are you a Pharmacist?
April 24, 2008 12:31:20 pm
Magnesium has benefits, but if anyone on here is thinking about just going and buying it. I recommend talking to a doctor you frequent or at the very least a nurse or pharmacist you are in contact with who knows your health history.
I don't think you can die from magnesium. But if you are on certain medications it is always a good idea to check because the drugs being produced today have SO MANY side effects. It's never bad to double check.
I have taken magnesium for other things before and in very small amounts and it helped. But I am not a doctor and suggest others consult a healthcare professional or at least research more before making a decision.
April 24, 2008 1:43:40 pm
Thanks Yoestoy ,,, I would check with our doc first ,my hubby takes Requip now . I was just wondering if this new poster was a doc or snake doctor .lol
April 24, 2008 1:46:19 pm
Ha!
Magnesium is naturally occuring in many foods. If you feel there is a deficiency, you can try adding magnesium rich foods.
Again, I'd ask a doctor or nurse practioner or even a dietician.
April 24, 2008 1:50:56 pm
I never even heard of restless leg syndrome until the tv commercials started. I expect a drug was produced to treat it, and then the commercials started to ensure a market.
April 24, 2008 2:09:34 pm
I've also found that people confuse restless leg with sciatic nerve problems.
Sciatic nerve problems can cause tingling sensations and pain in the legs and even toes, which can make them feel "restless".
I would seriously consult a few different healthcare providers to see what the root of it is before just taking a medication or a supplement.
April 24, 2008 2:22:46 pm
1. Every family should have a drug guide to check for interactions. Most nurses use the "Davis Drug Guide."
2. Before taking magnesium, you might try quinine water. It's a drink mixer--Canada Dry is one brand. Drink a small amount before bedtime and see if that helps. If it does, you can buy quinine tablets or have them prescribed.
3. If you want to take magnesium, most drug panels will list these levels. Ask your physician what your mag. level is. The docs usually prescribe MagOx which can be purchased OTC.
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