CASE REPORT article
Front. Pharmacol.
Sec. Neuropharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1697935
This article is part of the Research TopicPrecision Health Research in PsychiatryView all articles
Case Report: Near-Fatal Adverse Effects of Dopamine Agonist for the Treatment of Restless Legs Syndrome
Provisionally accepted
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, United States
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Background: The dopaminergic system plays a central role in motor control, goal-directed behavior, and the pathophysiology of multiple diseases including restless legs syndrome. Dopamine agonists such as pramipexole are commonly prescribed for the treatment of restless legs syndrome; however, growing recognition of potential serious adverse effects has led to updated clinical guidelines which now recommend against the routine use of dopamine agonists as initial therapy. Case Presentation: We present the case of a 64-year-old woman with severe restless legs syndrome and medically unexplained chronic pain who was psychiatrically hospitalized for active suicidal ideation. During her admission, it was discovered that a supratherapeutic dose of pramipexole was the source of iatrogenic harm. Her condition improved following medication taper, appropriate management of restless legs syndrome, and acute psychiatric interventions. Conclusion: Clinicians should be aware of the potential adverse effects associated with dopamine agonists and adhere to updated recommendations for the management of restless legs syndrome.
Keywords: Dopamine Agonist1, Restless Legs Syndrome2, chronic pain3, Adverse effects4, Suicidal Ideation5
Received: 02 Sep 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Joyce, Patarroyo Rodriguez and Sola. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jeremiah B Joyce, joyce.jeremiah@mayo.edu
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