Olanzapine-induced restless legs syndrome: Two case reports

Table 1 Summary of admission course, olanzapine dosage changes, restless legs syndrome onset, interventions and clinical outcomes in two patients with olanzapine-induced restless legs syndrome

Case	Admission information	Onset and clinical features of RLS	Therapeutic interventions	Improvement of clinical symptoms
1	Hospitalized in late November; RLS occurred on the 10th hospital day (December 9th)	Symptom onset on December 9th; intractable unexplained bilateral lower-extremity discomfort exacerbated at rest and alleviated by limb movement, accompanied by severe insomnia and sleep-related anxiety; baseline RLSS score = 22	December 9th: Eszopiclone discontinued, Tianmeng Oral Liquid 10 mL bid prescribed for insomnia	Complete resolution of lower-extremity discomfort and prominent sleep improvement on December 25th; RLSS decreased to 3; no newly emerging adverse drug reactions
			December 12th: Zopiclone 75 mg qn supplemented
			December 14th: Diagnosis of olanzapine-induced RLS confirmed; antipsychotic switching strategy implemented
2	Hospitalized in mid-November; initial RLS complaint on the 19th hospital day (December 9th), symptom aggravation on December 20th	Initial leg discomfort reported on December 9th and aggravated on December 20th; intolerable in-situ restlessness of lower limbs worsening at rest and partially relieved by physical activity, resulting in obvious sleep-onset difficulty; baseline RLSS score = 18	December 9th: Olanzapine dose elevation, lorazepam reduced to 1 mg qn; adjuvant biofeedback and occupational therapy provided	Markedly improved nocturnal sleep and substantial relief of leg discomfort 1 week after medication adjustment; RLSS declined to 5; psychiatric symptoms remained stable without additional adverse events
			December 20th: Olanzapine downtitrated; zopiclone 0.75 mg qn plus lorazepam 1 mg qn added

qn: Once nightly; bid: Twice daily; RLSS: Restless Legs Syndrome Rating Scale; RLS: Restless legs syndrome.