State of the art in restless legs syndrome therapy: practice recommendations for treating restless legs syndrome.
Dopaminergic agents are the best-studied agents and are considered first-line treatment of restless legs syndrome (RLS). Extensive data are available for levodopa, pramipexole, and ropinirole, which have approval for the indication RLS, and to a smaller extent for cabergoline, pergolide, and rotigotine. Apart from one recent study, comparing two active drugs (levodopa and cabergoline), no comparative studies have been published. The individual treatment regimen with the most appropriate agent concerning efficacy and side effects has to be selected by the treating physician. On the basis of these clinical trials and expert opinion of the authors, a treatment algorithm is proposed to support the search for the optimal individual treatment. Opioids and anticonvulsants such as gabapentine are second-line options in individual patients. Iron substitution is justified in people with iron deficiency related RLS (ferritin concentration lower than 50 microg/L).
Oertel
Wolfgang H
WH
Department of Neurology, Philipps-University, Marburg, Germany.
Trenkwalder
Claudia
C
Zucconi
Marco
M
Benes
Heike
H
Borreguero
Diego Garcia
DG
Bassetti
Claudio
C
Partinen
Markku
M
Ferini-Strambi
Luigi
L
Stiasny-Kolster
Karin
K
D000465:Algorithms; D015259:Dopamine Agents / Q000627:therapeutic use*; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D000090463:Iron Deficiencies; D012148:Restless Legs Syndrome / Q000188:drug therapy*
D015259:Dopamine Agents; D007501:Iron