Dealing with Restless Legs

Treatment strategies outlined for mild to severe restless legs syndrome in recent report

/ Author:  / Reviewed by: Dominique Brooks, M.D Beth Bolt, RPh

(RxWiki News) Researchers don't know what causes restless legs syndrome, which causes discomfort and a compulsion to move the legs when trying to sleep. But they have identified some treatment options for those who suffer from the disorder.

In a recent review, medical researchers updated the suggested plans for treatment for patients who are diagnosed with restless legs syndrome (RLS).

They described the different options for those with mild to moderate, severe and recurring symptoms. Treatments involving both lifestyle changes and prescription medicines were included.

The authors of the review wrote that more research and trials should be conducted to learn about the best way to manage RLS.

"If you have restless legs syndrome, talk to your doctor about treatment options."

Michael H. Silber, MBChB, of the Center for Sleep Medicine and Department of Neurology in the Mayo Clinic, and several colleagues wrote the review in order to address the management of restless legs syndrome.

Restless legs syndrome is a neurological condition that produces uncomfortable sensations in the legs and an urge to move them. Often, moving the legs temporarily relieves the discomfort.

The severity of RLS varies from patient to patient. Some people with severe cases have difficulty sleeping at night and have trouble performing basic tasks due to the discomfort.

Between 1.5 to 2.7 percent of the population experiences moderate restless legs syndrome symptoms at least twice a week. Although sometimes the disorder can be treated with lifestyle changes, more severe cases require medication.

Some medications that produce dopamine in the brain have been used to treat more severe cases. However, many of these drugs have side effects that patients choose to avoid, like nausea.

The review outlines several management strategies for patients with restless legs syndrome.

People with intermittent RLS experience troublesome symptoms less than twice a week on average. To treat these patients, doctors typically determine the patient's iron levels first. Sometimes, patients' symptoms go away with iron supplements if their iron levels are low.

Patients with mild cases can also try cutting caffeine out of their diet and performing activities that require mental alertness, like crossword puzzles.

Lastly, certain types of medication can help. Antidepressants are sometimes used to treat RLS symptoms, although some clinical trials have associated antidepressants with more severe symptoms.

Other medications can be used, like levodopa and carbidopa, which is typically a treatment for Parkinson's disease that encourages dopamine production. Certain painkillers and benzodiazepines, a class of sedatives and muscle relaxants, are sometimes prescribed for restless legs syndrome, especially if a patient is reporting disrupted sleep habits.

Chronic persistent RLS is characterized by frequent, uncomfortable symptoms occurring at least twice a week.

Patients with more severe restless legs syndrome can try the non-pharmacological options suggested for those with mild symptoms, but their treatment plan may also necessitate various types of medication.

Drugs that encourage more production of dopamine have been effective for severe symptoms of RLS, but they do not work for everyone.

Certain types of anti-seizure drugs like gabapentin and pregabalin are also used to treat severe symptoms. However, these drugs also have side effects that include drowsiness, weight gain and depression.

For refractory restless legs syndrome, when the symptoms do not improve with a medication treatment, the authors recommend rechecking iron levels, lifestyle changes and combinations of drugs.

The authors emphasize the importance of new clinical trials and studies on alternative therapies for RLS.

The review was published in Mayo Clinic Proceedings in September.

Information on funding sources was not available. Some of the researchers reported receiving financial support from pharmaceutical companies.

Review Date: 
October 4, 2013
Last Updated:
February 27, 2014