Abstract
A 54-year-old patient who had been treated by haemodialysis for the past 10 years complained of symptoms of restless legs syndrome over the past 7 years. All treatments were ineffective. Gabapentin 400 mg was administered just after dialysis and provided relief of symptoms. Three weeks later the symptoms reappeared 24 h after dialysis. The dosage was increased to 500 mg just after dialysis and then a second capsule of 400 mg was added the day after dialysis. After one year of therapy the patient reported complete relief of symptoms. This result was unexpected because gabapentin, according to its pharmacokinetics, would be expected to be effective even if administered only once. It might be possible to explain the result if an unknown extrarenal breakdown of the drug is involved.