We treat restless legs syndrome with Parkinson’s drugs, such as pramipexole (Mirapex). Will these drugs remain effective for treating Parkinson’s should the patients develop that condition later in life?
—DEANNA E. BURNS, FNP, Matthews, N.C.

No studies have yet been conducted to investigate this possibility primarily because the number of patients who are taking pramipexole for restless legs and have developed Parkinson’s is insufficient to reach any conclusions. However, in multiple trials looking at use of pramipexole in conjunction with carbidopa/levodopa, significantly lower dosages of these drugs were needed to be effective. While there is still a considerable gap in knowledge about the long-term effects of pramipexole on the dopaminergic system, trials suggest that at a minimum, the burnout factor would be mitigated by this drug. It is unclear whether newer drugs, like pramipexole, are “cleaner” and can accomplish their task without any overflow into other cells (to give one possible explanation), but the current literature does not justify a great deal of concern about future problems.
—Sherril Sego, MSN, FNP (118-1)