Restless Leg Syndrome, or RLS, is a sensory motor disorder in which a person has an uncontrollable urge to persistently move the legs to lessen discomfort. The discomfort may manifest as a tingling or creepy-crawly sensation or itchiness. The syndrome can cause sleep deprivation and lessen the quality of life. Doctors at the Mayo Clinic have published guidelines for treating RLS in the journal, "Mayo Clinic Proceedings" in which they note that the incidence of RLS in the general population is between 5 and 15 percent.
RLS Treatment
A main cause of RLS is nutrient deficiency and it is important to first determine levels of iron and folate in people that exhibit symptoms of RLS. Correcting nutrient deficiencies can alleviate or significantly reduce the symptoms of RLS. The National Institute for Neurologic Disorders and Stroke reports that some anti-nausea drugs and anti-depressants; the anti-seizure drugs, phenytoin and droperidol; the antipsychotic drugs, haloperidol and phenothiazine derivatives; and some cold and allergy medications aggravate the symptoms of RLS. Alcohol, caffeine and tobacco smoking are also known to intensify the symptoms of RLS. Decreasing the dose or modification of the frequency of taking the medications that increase RLS symptoms and discontinuing the use of alcohol, caffeine and cigarettes often lessen the severity of RLS symptoms. If patients still have symptoms, the Medical Advisory Board, or MAB, of the Mayo Clinic reports that four different classes of drugs are used to treat RLS. They are dopamine agonists, anti-convulsants, opioids and benzodiazepines.
Benzodiazepines
The mood stabilizing drugs used to treat RLS are benzodiazepines. These medications suppress the central nervous system allowing for relaxation and sleep. They do not suppress movements or sensations and are therefore often used in combination with a dopamine agonist. The MAB of the Mayo Clinic suggests that temazepam, triazolam, zolpidem or zaleplon may be helpful in treating RLS. Most often, low doses one to two hours before bedtime are prescribed. The most common side effects of benzodiazepines are daytime drowsiness, confusion and unsteadiness.
Dopamine Agonists
Dopamine is a chemical messenger in the brain that is involved in controlling movement of voluntary muscles. The most commonly used dopamine agonists used to treat RLS are pramipexole and ropinirole. A review on "Medscape" reports that both of these dopamine agonists were effective at low doses in treating RLS in clinical trial studies. The most common side effects of dopamine agonists are nausea, drowsiness and light-headedness.
References
- MayoClinic: Algorithm for the Management of Restless Leg Syndrome
- Talk About Sleep: An Introduction To Restless Legs Syndrome (RLS)
- National Institute for Neurologic Disorders and Stroke: Restless Leg Syndrome Fact Sheet
- Medscape Continuing Medical Education: The Treatment and Management of Restless Legs Syndrome
