Pathologic Gambling as a result of Restless Leg Syndrome: I gotta get down!

So just what IS restless leg syndrome? I've always thought it was just stress manifesting itself in the middle of the night and a brief stroll around the bedroom or a good stretch and it goes away. Apparently, it's way more prevalent in the U.S. and several new drugs for treatment have recently been approved by the FDA. Now for a medical definition:

Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described by people as burning, creeping, tugging, or like insects crawling inside the legs. Often called paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), the sensations range in severity from uncomfortable to irritating to painful.
The most distinctive or unusual aspect of the condition is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes exhaustion and daytime fatigue. Many people with RLS report that their job, personal relations, and activities of daily living are strongly affected as a result of their exhaustion. They are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks.

Current treatment involves dopamine agonist treatment. One such drug is Requip, drug name ropinirole. In 2005, requip became the only drug approved by the U.S. Food and Drug Administration specifically for the treatment of moderate to severe RLS. The drug was first approved in 1997 for patients with Parkinson’s disease. Requip stimulates D2 and D3 type dopamine receptors, to stimulate motor neuron firing (activity-or signaling). The specific mechanism of action for the indication of both Parkinson's and RLS are unknown.

The side effects of ropinirole are interesting to say the least. It has been reported that dopamine receptor agonists stimulate compulsive gambling ( NEUROLOGY 2007;68:301–303). Three subjects were followed from either never gambled or 1-2 visits to a casino to visiting a casino 3-4 times a week and losing up to several hundred thousand dollars. One possible mechanism of action is the stimulation of D3 receptors, the highest concentration of which is found in the mesolimbic pathways [in the brain, centers for controlling the following functions] implicated in motivation, emotion, and reward behaviors, which could lead to the development of pathologic
gambling.
I can understand the "reward" part of the gamble--USC 2nd half football games the last 2 years have paid rents. Just goes to show how pharmacological manipulation of brain function can have drastic effects.

Coming tomorrow....Dopamine agonists and getting down on some ACTION!

a tease:
Compulsive gambling with extreme losses -- in two cases, greater than $100,000 -- by people without a prior history of gambling problems has been linked to a class of drugs commonly used to treat the neurological disorder restless legs syndrome (RLS). A new Mayo Clinic study is the first to describe this compulsive gambling in RLS patients who are being treated with medications that stimulate dopamine receptors in the brain.

Mechanism of action and my interpretation tomorrow (later today).....