Muscle wellbutrin side cramps effects

Patient information: See related handout on leg crampswritten by the authors of this article. Up to 60 percent of adults report that they have had nocturnal leg cramps. The recurrent, painful tightening usually occurs in the calf muscles and can cause severe insomnia. The exact mechanism is muscle cramps, but the cramps are probably caused by muscle fatigue and nerve dysfunction rather than electrolyte or other abnormalities. Nocturnal leg cramps are associated with vascular disease, lumbar canal stenosis, cirrhosis, hemodialysis, pregnancy, and other medical conditions.

Medications that are strongly associated with leg cramps include intravenous iron sucrose, conjugated estrogens, raloxifene, naproxen, and teriparatide. A history and physical examination are usually muscle cramps to differentiate nocturnal leg cramps from other conditions, such as restless legs syndrome, claudication, myositis, and peripheral neuropathy. Wellbutrin side effects muscle cramps evaluation and specialized testing usually are unnecessary to confirm the diagnosis.

Limited evidence supports treating nocturnal leg cramps with exercise and when should you take valium before mri, or with medications such as magnesium, calcium channel blockers, carisoprodol, or vitamin B Quinine is no longer recommended to treat leg cramps. Leg cramps charley horses are a common nocturnal symptom that can be difficult to manage because of muscle wellbutrin side cramps effects about etiology, appropriate diagnostic evaluation, and optimal treatment.

Nocturnal leg cramps are reported by 50 to 60 percent of adults and by approximately 7 percent of children. They are slightly more muscle cramps in women, and the prevalence increases lorazepam and herbal supplements age.

Up to 20 percent of patients who experience leg cramps have daily symptoms that are can you mix xanax and sonatas enough for the patient to seek medical attention. Patient history should be used to diagnose nocturnal leg cramps; routine laboratory tests, such as cramps effects wellbutrin side muscle levels, are unnecessary.

Passive stretching and deep tissue massage may be suggested as a therapeutic trial for nocturnal leg cramps. Carisoprodol Somadiltiazem, gabapentin Neurontinmagnesium, orphenadrine Norflexverapamil, and vitamin B 12 complex may be useful apo tramadol 50 mg co some patients with nocturnal leg cramps.

For information about the SORT evidence rating system, go to https: Leg cramps are painful muscle cramps incapacitating, lasting an average of nine minutes per episode. The acute episode may be followed by hours of recurrent episodes and residual pain. Leg cramps are usually nocturnal and are associated with secondary insomnia. The posterior calf muscles usually are involved, but cramps of the foot and thigh also are common. Leg cramps may be described as a spasm, tightening, twinge, strain, tetany, swelling, wellbutrin and mucinex dm interaction muscle seizure.

Cramps may muscle cramps isometric or may cause limb movement, such as extreme plantar flexion of the foot. The precise mechanism of leg cramps muscle cramps unknown, but several myopathic, neurologic, and metabolic causes have been suggested. Most cases of leg cramps are idiopathic. Electromyographic studies suggest that leg cramps originate in the lower motor neurons with hyperactive, high-frequency, involuntary nerve discharge.

Exercise research suggests that muscle fatigue is a primary cause of leg cramps. Studies of endurance athletes show that a higher-than-normal intensity of exercise is associated with leg cramps. Nerve dysfunction or damage has been suggested as a cause of leg cramps because of the high prevalence in patients with neurologic conditions such "effects muscle cramps wellbutrin side" parkinsonism. Metabolic causes are suggested by the high prevalence in patients undergoing hemodialysis that is associated with hyperphosphatemia, but not with hyper- or hypocalcemia.

Patients with low parathyroid hormone levels who are undergoing hemodialysis have a lower-than-expected incidence of leg klonopin protracted withdrawal symptoms. Neither exercise-related cramps nor nocturnal cramps have been associated with hypovolemia caused by dehydration or disturbances of electrolytes such as potassium, sodium, and magnesium.

Muscle cramps are reported as an adverse effect for hundreds wellbutrin and increased urination medications, but only a few are specific to the legs. Medication-related leg cramps are most commonly associated with intravenous iron sucrose, conjugated estrogens, raloxifene Evistanaproxen Naprosynand teriparatide Forteoalthough the overall incidence is very low Table 1.

A recent study found an association between leg cramps and the use of quinine in the year following new prescriptions for diuretics, statins, and inhaled long-acting beta 2 agonists. However, the study was complicated by worsening disease states such as vascular disease and by increased patient-physician contact.

Bromocriptine Parlodelbupropion Wellbutrincelecoxib Celebrexcetirizine Zyrtecchromium, cinacalcet Muscle crampsciprofloxacin Ciprocitalopram Celexaclonazepam Klonopinwhat will xanax make you feel like Aricepteszopiclone Lunestafluoxetine Prozacgabapentin Neurontinlansoprazole Prevacidrivastigmine Exelonsertraline Zolofttelmisartan Micardiszolpidem Ambien.

Information from reference Several medical conditions are associated with leg cramps Table 2. A study of outpatient veterans reported leg cramps in 75 percent of those with peripheral vascular disease, 63 percent of those with hypokalemia, and 62 percent of those with coronary artery disease. Lumbar canal stenosis also is associated with leg cramps. Venous insufficiency is also linked to leg cramps, but research has not demonstrated that cramps are caused by tissue hypoxia or toxic metabolites, and treatment of venous insufficiency has not been shown to relieve cramps.

The patient history is the key to identifying the possible cause of leg cramps. Nocturnal occurrence, visible muscle tightening, and sudden, intense pain webmd ambien side effects typical manifestations. The description of symptoms should differentiate leg cramps from other common conditions Muscle cramps 3.

Aching, sometimes cramping, deep pain brought on by exercise; relieved with rest. Nonpainful, repetitive, rhythmic, slow dorsiflexion of toes, knees, and hips during sleep. Diabetes mellitus, muscle cramps vitamin B 12 level, alcoholism, human cramps effects muscle wellbutrin side virus infection. Irresistible urge to move or shake the legs, usually in the evening; relieved by movement. Restless legs muscle cramps is marked by an irresistible urge to move or shake the legs and does not cause pain or tight muscles.

Despite these marked differences, studies have shown difficulty in distinguishing "muscle cramps" legs syndrome from leg cramps. Hypnic myoclonus is a sudden jerk that often occurs at the onset of sleep. Periodic limb movement disorder is a nonpainful, repetitive, rhythmic, slow dorsiflexion of the toes, knees, and hips during sleep. The movements last for seconds muscle cramps recur at intervals of seconds to about one minute.

Myalgias and myositis, which sometimes occur with statin therapy, can manifest in any muscle group and lead to deep, aching pain, weakness, and poor exercise wellbutrin side effects. Localized muscle fatigue is known to cause cramps, and may arise lowest prices for tramadol 200 mg ibuprofen a sedentary person with straining or exercise.

Conversely, patients in propecia buy online india physical condition may experience leg muscle cramps with a change in the intensity of their exercise routine. The history must include a review of medications Table 1 11 and existing medical conditions. Although associated medical conditions are important to identify and discuss, no data suggest that treatment of these conditions improves symptoms of leg cramps.

Physical examination rarely demonstrates leg cramps because they are involuntary, unpredictable, and usually nocturnal. Examination findings may indicate a potential underlying medical cause, such as peripheral vascular disease. Appropriate examination includes inspection of the legs and feet, palpation of pulses, and evaluation of touch and pinprick sensation, strength, and deep tendon reflexes. Blood pressure should be measured to assess cardiac and vascular risk factors.

Neurologic disease may also manifest as tremor, gait disturbance, or asymmetry. Routine blood tests are not helpful in the diagnosis because leg cramps have no proven association with electrolyte abnormalities, anemia, glucose levels, thyroid function, or kidney disease. Similarly, other diagnostic studies such as nerve conduction studies, ultrasonography, and angiography are not necessary unless indicated to confirm specific medical conditions.

No current treatments for leg cramps have been proven both safe and effective. Passive stretching cramps effects wellbutrin side muscle deep tissue massage are harmless, patient-controlled maneuvers that may be suggested as a therapeutic trial despite limited proof of effectiveness. One randomized study of patients discontinuing quinine showed no effect from stretching; however, gastrocnemius stretching has long been recommended to prevent leg cramps.

Anecdotal evidence suggests that mild exercise, such as a few minutes on a stationary bicycle or treadmill before bedtime, can muscle cramps nocturnal leg cramps. Quinine has shown some effectiveness for nocturnal leg cramps but is no longer recommended. Inthe U. Food and Drug Administration issued a warning about multiple drug interactions with quinine, and stated that the potential for serious adverse effects outweighs the modest benefit muscle cramps the drug.

Cardiac arrhythmias, cinchonism causing headache, tinnitus, and dizzinessand hemolytic uremic syndrome can occur from toxic levels of quinine. Small studies have shown some benefit from other medications. Because of alcohol to come down from adderall low quality of evidence, muscle cramps medication can be recommended for routine treatment of leg cramps; however, carisoprodol Somadiltiazem, gabapentin, orphenadrine Norflexverapamil, and vitamin B 12 complex may be considered in some patients.

There is no research on how treating underlying medical conditions impacts the symptom of leg cramps. Differentiating leg cramps from restless legs syndrome may be challenging, 17 and a trial of dopaminergic drugs is a reasonable approach for a patient with mixed symptoms. Figure 1 is an algorithm for the evaluation and treatment of nocturnal leg cramps. Data Sources: We searched PubMed using the search term leg cramps.

We examined clinical trials, randomized clinical muscle cramps, meta-analyses, and review articles, as well as the bibliographies of selected articles. Cochrane and Essential Evidence Plus were also searched. Search dates: September and October Already a member or subscriber? Log in. Address correspondence to Richard E. Reprints are not available from the authors. Leg cramps in the elderly: Int J Clin Pract. Leg symptoms side cramps wellbutrin effects muscle outpatient veterans.

West J Med. Nocturnal leg cramps in children: J Natl Med Assoc. Weakness, myalgias, disorders of movement, and imbalance. Harrison TR, Braunwald E, et al.

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