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Case Reports
. 2022 Dec 15;8(12):e12258.
doi: 10.1016/j.heliyon.2022.e12258. eCollection 2022 Dec.

Restless arms syndrome with oral olanzapine: case based review

Qijie Kuang  1 , Sumiao Zhou  1 , Rumeng Huang  1 , Yingjun Zheng  1 , Shenglin She  1
Affiliations
Case Reports

Restless arms syndrome with oral olanzapine: case based review

Qijie Kuang et al. Heliyon. .

Abstract

Background: Restless arms syndrome (RAS) is a specific variant of restless legs syndrome (RLS). RAS is characterised by an uncomfortable, painful, burning or uneasy sensation confined to the arm.

Case presentation: We report a case of RAS with oral olanzapine, which improved with medication reduction. In addition, all reported cases of RAS were reviewed to explore the underlying mechanisms, diagnosis and treatment for psychiatric drug-induced RAS. The literature review and new case suggest that iron deficiency may be a predisposing factor for RAS. Psychiatric medications are closely associated with RAS, especially olanzapine, quetiapine, and mirtazapine. Discontinuation is the recommended treatment for psychotropic drug-induced RAS, while α2δ calcium channel ligand drugs and benzodiazepines may be considered.

Conclusion: In conclusion, psychiatrists should be alert to the possibility of RAS when administering psychiatric medications for the first time to psychiatric patients with iron deficiency.

Keywords: Case report; Olanzapine; Restless arms syndrome (RAS); Review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The mechanism of olanzapine induced-RAS (Improvements based on the study of Ferre et al., 2019). PLMS, periodic leg movements; PAMS, periodic arm movements.
Figure 2
Figure 2
The treatment process of RAS. Mild means a score of 1–10 on the RAS self-rating scale; Moderate means a score of 10–20; Severe means a score of 20 or more. RAS, Restless arms syndrome.
See this image and copyright information in PMC

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