LETTER TO EDITORS
Letter
Sirs.
Restless legs syndrome induced by subtherapeutic dose of mianserin
Recently, Paik et al. (1989) reported that mianserin (60-90 mglday) induced the restless legs syndrome (RLS) in three depressed patients. We report two cases who developed RLS on lower doses-even as little as 10 mg of mianserin.
Case 1 was a 54-year-old menopausal woman who suffered from major depression (DSM-111-R). She took 30 mg of mianserin (her first dose) at 9 p.m. and fell asleep at 10 p.m. However, her sleep was disrupted 30 minutes later by creeping, tired and restless sensations in her calves. She could not keep her legs still because of these exceedingly uncomfortable sensations. To seek relief, she vigorously moved, held or rubbed her legs, but with no effect. At last, she had to get up and wander around. It took two hours for her symptoms to be relieved and for her to fall asleep again. During the next five weeks, the dose was kept constant and her depressive symptoms did not improve. The dose was then gradually increased. On the night of taking 50 mg of mianserin, she again developed disturbing restless legs. This dose was maintained for two weeks with no significant improvement in depression. The dose was then reduced to 30 mgl