Drug Treatment for Severe Restless Legs Syndrome
Restless legs syndrome (RLS) is a common disorder, characterised by a pressing need to move the extremities. It is associated with paraesthesias, motor restlessness, and worsening of symptoms at rest and during the evening or at night. The exact cause of the disorder is not known, but RLS is thought to involve the subcortical CNS with involvement of the brainstem and spinal cord, and is classified as idiopathic or symptomatic (secondary). In secondary RLS, the primary illness should be identified and treated if possible. In patients with disease severe enough to warrant drug treatment (see Differential features table), levodopa is the agent of first choice; alternatives include other dopamine agonists, opioids and benzodiazepines. Patients also benefit from general measures, including initiation of good sleep hygiene practices (see guidelines).


(Enlarge Image)