Dear Dr. Roach: I鈥檓 a mother of a 49-year-old woman with special needs. She has tuberous sclerosis and a touch of autism. She has been on Abilify for more than six years to control the behavioural problems.
However, it also has given her uncontrolled muscle jerking, causing her to spill her drinks and meals.
I would like to know if there is another medicine that she can use. I鈥檝e been told this shaking and jerking of her left arm can become permanent. Her doctor says she needs to stay on it.
G.D.
Tuberous sclerosis is a disease that causes abnormal non-cancer growths in many parts of the body, and frequently causes learning disabilities and autistic-type behaviour. Aripiprazole (Abilify) is an antipsychotic medication often used to treat behavioural issues in people with many psychiatric conditions, including schizophrenia and autism.
The side effect of arm jerking is called an extrapyramidal side effect. While there are many drugs used to moderate behavioural issues in people like your daughter, aripiprazole is one that has a lower incidence of this particular side effect than most.
I can鈥檛 tell you to disregard the advice of your daughter鈥檚 psychiatrist; however, sometimes reducing the dose can stop or reduce the side effect while still being effective for the behaviours. Some experts use other medications to help with the side effect. The most common include lorazepam, propranolol or benztropine, which acts directly on the nerve endings in the brain.
听
Dear Dr. Roach: Don鈥檛 forget that although there are many medical causes of restless leg syndrome, varicose veins also can be a source of symptoms, and we have cured many people of symptoms with minimally invasive treatments.
We always recommend that if you have visible varicosities or strong family history of varicose veins, you should get an ultrasound to determine if you have venous insufficiency.
Melissa A. Sandman, M.D.
In addition to the iron deficiency, there are several other causes of varicose veins, including kidney disease, usually when dialysis has started. Diabetics have a higher risk for RLS, which sometimes can be mistaken for diabetic neuropathy. Multiple sclerosis and Parkinson鈥檚 disease are both associated with RLS, and Parkinson鈥檚 is important because when medicines such as levodopa/carbidopa (Sinemet) wear off, it can mimic RLS symptoms.
