Medications to Treat Restless Legs Syndrome

Can medications be used to treat individuals with RLS?
Drug therapy may be initiated if appropriate treatment of an underlying disorder has not alleviated associated RLS; it is a treatable idiopathic form of RLS; or lifestyle changes have not appropriately improved symptoms. The pharmacologic treatment of RLS may be extremely complex and must be carefully adapted to most effectively and appropriately treat each individual with the disorder. According to the medical literature, the large number of different drugs that may be used to help treat patients demonstrates the complexity of RLS management.

Physicians typically consider a number of factors when initiating drug therapy for RLS. For example, because certain drugs may aggravate other conditions that are present (comorbid conditions) or may help alleviate certain conditions, physicians consider a patient's medical history (including any diagnosed disorders, current medications, etc.) in determining which medications to prescribe. If possible, physicians may attempt to treat RLS and another existing condition with a single, appropriate medication.

When a particular drug therapy is initiated for the treatment of RLS, the medication is usually started at a low dose and then gradually increased as necessary to the minimum level of effectiveness. Physicians may suggest that medication be taken early enough in the evening to help ensure proper absorption and effectiveness before sleep onset. In addition, they may stress that the medication should be taken only as needed, such as during certain circumstances that provoke symptoms or on those days during which symptoms usually occur.

If a drug that was initially prescribed for RLS has proven ineffective after appropriate adjustments in dosage, a second medication from the same class of drugs or from a different class of drugs may be substituted. In other cases, another medication may be added to the regimen, in which case the initial medication's dosage may be adjusted as required. If increasingly higher dosages of a specific medication are required to ensure its continued effectiveness (known as developing tolerance), physicians may temporarily suspend the drug's use or prescribe a different medication.

In some patients, symptoms may vary in range and severity or may cease altogether for a period of time (remission). Therefore, physicians may periodically recommend attempting a withdrawal of pharmacologic therapy to assess the necessity for ongoing treatment.

What are the classes of drugs typically used to treat patients with RLS?
The major classes of drugs used to treat individuals with restless legs syndrome include dopaminergic agents, benzodiazepines, opioids, and, in some cases, anticonvulsants. Other types of medications may be prescribed in combination with the major RLS drugs, or in certain special cases.

	Dopaminergic Agents