Medications Treatment for Restless Legs Syndrome

Your doctor will make a diagnosis of Restless Legs Syndrome based on the symptoms you have as well as physical examination, your medical history, and your family history. Your doctor will also do a neurological examination to look for nerve damage and might order routine blood tests to check for vitamin or iron deficiency, kidney problems, or diabetes. If the body’s stores of iron are low, iron supplements may relieve the symptoms of Restless Legs Syndrome.  

During sleep, several people with Restless Legs Syndrome also have involuntary jerking leg movements. The movements happen 1-10 times per minute. A sleep study could regulate how much this is happening and how it affects your sleep. In various cases, an overnight sleep study at a sleep clinic may be needed.

Treatment of Restless Legs Syndrome depends on the severity of your symptoms. If your symptoms are mild, taking a hot bath, simply exercising, massaging, or stretching your legs may bring relief. Lifestyle changes may also help, especially following a balanced diet and avoiding alcohol, caffeine, and cigarette smoking. Iron treatment might be helpful even in the absence of iron deficiency. Lots of experts also recommend mentally challenging activities, such as video games or crossword puzzles, to lessen symptoms.  

Many medications, taken alone or in combination, may be effective for the treatment of Restless Legs Syndrome.  These medication treatments may include: 

  • Dopaminergic agents: These medications typically relieve the discomfort of Restless Legs Syndrome symptoms and improve sleep quality. They include Pramipexole (Mirapex), Carbidopa/Levodopa (Sinemet), Ropinirole (Requip), and the Rotigotine patch (Neupro). Due to their safety profile, Ropinirole and Pramipexole are usually the first choices of medication treatment for Restless Legs Syndrome. 
  • Benzodiazepines: These types of medications are sedatives that improve sleep quality. Short-acting agents such as Triazolam (Halcion), Clonazepam (Klonopin), and Zolpidem (Ambien) are usually best for Restless Legs Syndrome.
  • Anticonvulsants: These medications are especially useful in patients whose symptoms are painful. They include Pregabalin (Lyrica), Gabapentin (Neurontin), and Carbamazepine (Tegretol). 
  • Others: Tramadol (Ultram), Amantadine, Clonidine (Catapres), and Propranolol (Inderal) also may be useful for the treatment of this condition. Tramadol is a non-opioid pain reliever that occasionally is recommended. 
  • Opioids: These are narcotics such as Oxycodone and Codeine that relieve pain and might suppress Restless Legs Syndrome in people with severe, pounding symptoms that do not respond to other treatments. 
  • Vibration therapy: In 2014, the Food and Drug Administration (FDA) has approved a vibrating pad as a non-medication treatment for Restless Legs Syndrome.  Studies recommend this treatment could be helpful but not all experts are convinced of its effectiveness. It is mostly well tolerated, but sometimes it causes a temporary worsening of symptoms, soreness, and motion sickness as well as leg cramps. 

Several people with Restless Legs Syndrome also have periodic limb movement disorder (PLMD). It is a common movement disorder that causes jerking leg movements during sleep. The movements happen 1 to 10 times every minute. The degree of periodic limb movement and how it affects sleep is best assessed with a sleep study.  

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