new treatments for Restless Legs Syndrome (RLS)

You'll see new treatments for Restless Legs Syndrome (RLS).

This syndrome affects about 5% of adults...with a higher incidence in the elderly.

These patients have unusual sensations in their legs that are usually worse at rest and relieved by movement. This leads to involuntary leg movements at night that interfere with sleep.

Benzodiazepines (clonazepam, etc) are useful for mild symptoms...they help patients sleep in spite of their restless legs.

Dopamine agonists are often effective for more disruptive symptoms.

Levodopa/carbidopa (Sinemet) is usually tried first...but it's short-acting. Its effects may wear off before morning...or may cause rebound symptoms the next day.

Suggest taking both regular AND sustained-release Sinemet at bedtime to prolong its effects.

Or recommend switching to a newer dopamine agonist...pergolide (Permax)...pramipexole (Mirapex)...or ropinirole (Requip).

These drugs can cause nausea...dizziness...and hypotension.

There's also concern about new reports of "sleep attacks" in patients taking Mirapex or Requip for Parkinson's. This sudden sleepiness has led to some car accidents.

Patients who can't tolerate a dopamine agonist sometimes try gabapentin (Neurontin), opiates, clonidine, or baclofen.

Remind patients that caffeine, smoking, and alcohol can exacerbate restless legs syndrome.

For patients who want more info about this disorder, suggest the Restless Legs Syndrome Foundation at www.rls.org.

• Other: Restless Legs Syndrome