Khosro Hekmat
When the medication itself makes the illness worse. It is the most treacherous complication of RLS treatment. Where a dopamine drug helped well at first, the symptoms become worse over time than they ever were: they start earlier in the day, spread to the arms, return more quickly. And the obvious response, raising the dose, makes exactly that worse. The new edition first explains the dopamine system, the receptors D1 to D5 and the mechanisms by which an effective treatment turns into a worsening. It names the five warning signs, separates rebound, tolerance and progression, and presents the augmentation algorithm in six steps, each with its own flowchart. The way out of augmentation gets chapters of its own: cross-taper, α2δ ligands, opioids, iron, and ten worked cases show week by week how it unfolds. Newly evaluated are the major RLS reference works, the guidelines up to 2025 and the patient guides of the German Restless Legs Association. A separate chapter examines what textbooks and guidebooks say about augmentation and what they leave out. 31 chapters, over 300 professional sources, every statement referenced. WHAT IS IN THE BOOK- The dopamine system and the receptors D1 to D5, understandable without prior knowledge- How an effective treatment turns into a worsening: eight leads- The five warning signs, rebound, tolerance and progression- The algorithm in six steps with twelve flowcharts- Cross-taper, α2δ ligands, opioids and iron: the way back- Ten worked ways out of augmentation- Prevention: why the dose should stay low- What textbooks and guidebooks say about augmentation WHO THIS BOOK IS FORFor everyone taking or having taken a dopamine drug, for patients whose symptoms are increasing despite treatment, and for relatives who want to make sense of the course it has taken. ABOUT THE SERIESVolume 8 of 52 in the book series on restless legs syndrome, part 'Treatment'. Every volume can be read on its own. The statements in this volume rest on 347 professional sources, each one listed individually in the reference section.
