Current treatment options for restless legs syndrome.
Restless legs syndrome (RLS) is a common but often underdiagnosed neurological disorder characterised by an imperative desire to move the extremities associated with paraesthesias, motor restlessness, worsening of symptoms at rest in the evening or at night and, as a consequence, sleep disturbances particulary. Additionally, most patients with RLS have periodic limb movements during sleep and relaxed wakefulness. The aetiology of RLS remains unknown. Treatment of RLS is generally symptomatic, a causal therapy is possible only in the secondary forms. Dopaminergic agents including levodopa and dopamine agonists such as pergolide, pramipexole, cabergoline and ropinirole are regarded as the treatment of choice for idiopathic RLS, however, the development of augmentation of symptoms, especially under levodopa therapy, may be a major problem. Except in special circumstances, opioids and anticonvulsants such as gabapentin or benzodiazepines, are regarded as second-line treatment. In secondary RLS, the underlying illness should first be treated, although dopaminergic drugs may also be helpful.
Wetter
Thomas C
TC
Max Planck Institute of Psychiatry, Kraepelinstrasse 10, D-80804 Munich, Germany. wetter@mpipsykl.mpg.de
Winkelmann
Juliane
J
Eisensehr
Ilonka
I
D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D015259:Dopamine Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000927:Anticonvulsants; D015259:Dopamine Agents; D009294:Narcotics