Restless legs syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

In patients with mild symptoms of restless legs syndrome, no treatment may be required, although all patients should be screened for iron deficiency.^[1]

• Pharmacologic medical therapy is recommended among patients with persistent or moderate to severe symptoms of restless legs syndrome.^[1]
• Pharmacologic medical therapies for restless legs syndrome include dopamine agonists, alpha-2-delta calcium channel ligands and opioids.^[1]

• The treatment of restless legs syndrome must be individualized to each patient.^[1]
• In patients with mild symptoms, no treatment is required.^[1]

• Preferred regimen (1): pramipexole^[2]
  • Treatment with pramipexole is started at a dosage of 0.25 mg per day, and progressively increase until the optimal therapeutic effect is obtained.
• Preferred regimen (2): Ropinirole^[3]
  • It is important to take ropinirole prior to symptom onset.
  • For daily RLS, ropinirole may be started at 0.25 mg per day at 2 hours before RLS symptom onset, and then increased by 0.25 mg every 2 to 3 days until symptom relief is achieved (Silber et al 2004). Starting dose should be individualized based on RLS severity and age.
  • The effective dose for ropinirole is typically 2 mg or less.
  • Some patients may require doses as high as 6 mg/day.
• Preferred regimen (3): Carbidopa/levodopa 25/100 mg PO daily at bedtime^[1]
• Alternative regimen (1): Gabapentin 300–1200 mg daily about 1 h before bedtime.^[1]

Template:WH Template:WS