Levodopa for idiopathic restless legs syndrome: evidence-based review.
Restless legs syndrome (RLS) is a sensory motor disorder characterized by a distressing urge to move the legs and sometimes also other parts of the body usually accompanied by a marked sense of discomfort or pain in the leg or other affected body part. The prevalence of RLS is estimated at 2.7 to 5% of adults and it is more common in women. The treatment of RLS with levodopa has been reported thus a systematic synthesis of evidence is necessary to evaluate the effectiveness and safety of levodopa for RLS. Systematic review of randomized or quasi-randomized, double blind trials on levodopa. Relief of restless legs symptoms marked on a validated scale, subjective sleep quality, sleep quality measured by night polysomnography and actigraphy, quality of life measured by subjective measures, adverse events associated with the treatments. Nine eligible clinical trials were included. The subjective analyses of these studies showed contradictory results, although the objective analyses showed that treatment group had a statistically significant improvement of periodic leg movement (PLM) index, favoring the treatment group. The most commonly adverse event seen was gastrointestinal symptoms. The short-term treatment with levodopa was demonstrated effective and safety for PLM, but there was only few trials assessing long-term treatment and the augmentation phenomenon in RLS. Further long-term randomized controlled trials using standard follow-up measurements as the International RLS Study Group Rating Scale are necessary.
Department of Emergency Medicine and Evidence Based Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.
Cristiane Fiquene
CF
Conti
Márcio Moysés
MM
de Oliveira
Regis Bruni
RB
Andriolo
Humberto
H
Saconato
Alvaro Nagib
AN
Atallah
Juliana Spelta
JS
Valbuza
Luciane Bizari
LB
Coin de Carvalho
Gilmar Fernandes
GF
do Prado
D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D019317:Evidence-Based Medicine; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use*; D008134:Long-Term Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012148:Restless Legs Syndrome / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa