RLS , caffeine and dopamine agonist

[MDpride]

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In our notes, prof. says exacerbation by caffiene is one of the diagnostic clue for RLS.
Then, in treatment, notes says use dopamine agonist and abstain from caffeine, nicotine.

How is dopamine agonist different from caffiene?
caffiene blocks dopamine reuptake which i believe is same as dopamine agonist because both increase the dopamine effect.

please help.

 

[TMP-SMX]

Well it has a similar effect but it is not the same thing. A reuptake inhibitor requires certain levels of dopamine which someone with something like RLS or Parkinsons does not have (at least at night with RLS as dopamine normally drops at night). A Dopamine agonist works at the actual dopamine receptors in the extrapyramidal system. As for caffeine, I think we all know the effect it can have by giving us "jitters" if we have a little too much in even normal individuals.

Keep in mind that ferritin levels are often found to be low in patients with RLS and that is also treated. This is one reason that RLS shouldn't be something diagnosed without looking at every possible abnormality and trying to fix those (too much caffeine is also an example) before going to expensive drugs that are direct-marketed to consumers like Mirapex and Requip.