Restless Leg Syndrome

Treating

In most cases, restless legs syndrome is a lifelong condition-though some people may go days or months without any symptoms. For those people, or for others whose symptoms do not affect their quality of life, no treatment may be necessary. Read more about managing RLS in the Management section. For people with more severe symptoms, medicines are available. Several medications may be used to treat RLS, although most are not specifically approved for that purpose.

Some medications can make restless legs worse. These include some antihypertensive medications (taken for high blood pressure) and antidepressants. Your doctor may recommend stopping these medications, finding alternatives that do not worsen your symptoms, or adding medications to treat RLS.

Although RLS can often worsen--or appear for the first time--during pregnancy, doctors usually don't recommend taking drugs for the condition during pregnancy. If symptoms are severe, a pain medication may be acceptable, especially in the third trimester.

If the symptoms of restless legs syndrome are being caused by another disease, such as peripheral neuropathy or diabetes, treating the underlying disease may reduce the symptoms. Similarly, because low blood levels of iron can also cause these disorders, treating anemia may relieve the symptoms.

This section contains more information on:

• Medications for RLS
• Treating iron deficiency

Medications for RLS

The medications most commony prescribed for restless legs syndrome are dopaminergic agents, benzodiazepines, opioids, and anticonvulsants. For people whose symptoms come and go, medications are taken only when the symptoms are a problem.

The class of drugs known as dopaminergic agents are normally the first choice for RLS. These drugs are approved mainly to treat Parkinson's disease; they alter the activity of dopamine, a chemical that carries messages in the central nervous system. However, ropinorole (brand name Requip) has also been approved by the Food and Drug Administration for moderate to severe RLS. Other dopaminergic drugs that may be given, although the Food and Drug Administration has not approved them for use in RLS, include levodopa plus carbidopa (Sinemet), pergolide (Permax), and pramipexole (Mirapex). Side effects include dizziness, drowsiness, nausea, and vomiting. Augmentation, in which symptoms appear earlier in the day, is a problem with long-term use of these drugs. The solution to this problem is usually switching to another drug.

Benzodiazepines are a widely used group of sedatives, often prescribed for insomnia. They work by depressing the central nervous system. This group includes such drugs as diazepam (Valium), temazepam (Restoril), and clonazepam (Klonopin). A common side effect from these sedatives is sleepiness lasting into the next day.

Opioids such as codeine and oxycodone (OxyContin) may also be given for RLS. These drugs relieve pain and cause relaxation. Side effects include nausea, dizziness, and constipation. If these drugs are used long term, addiction can be problem.

Some doctors may recommend anticonvulsants such as carbamazepine (Tegretol) or gabapentin (Neurontin) to ease the creepy-crawly feelings of RLS. Side effects include dizziness and drowsiness.

Treating iron deficiency

In some people, RLS appears to be caused, or worsened, by iron deficiency. If blood tests determine that you are anemic, your doctor may recommend iron supplementation. Oral iron supplements can cause constipation; eating a high-fiber diet may counteract this effect, or your doctor may tell you to take the supplement with a stool softener or to reduce the dose. For some people, intravenous delivery of iron may be necessary.