Restless leg syndrome, or RLS is a neurological disorder characterized by an unpleasant urge to move your legs to stop uncomfortable or odd sensations. RLS sensations usually occur at night and may interfere with sleep. People with RLS may experience daytime tiredness, mood disturbance and inability to perform daily activities. The neurotransmitter called dopamine appears to be mostly involved with this condition.
Cause
The exact cause of restless leg syndrome is still not known. According to Mayo Clinic, the condition may be caused by an imbalance of dopamine, a neurotransmitter which transmits signals between nerve cells in the brain. Dopamine helps control muscle movements by sending messages to the brain.
Treatment
Medication may be required when RLS disrupts or prevents sleep. According to Mayo Clinic algorithm, dopamine agonists such as pramipexole, levodopa and ropinirole have been approved by the Food and Drug Administration for the treatment of restless leg syndrome. These medications reduce the amount of motion in your legs by boosting your dopamine levels in the brain. A meta-analysis study published in 2008 in "Sleep Disorder" compared the effect of pramipexole and ropinirole in patients with restless leg syndrome. Researchers found that both drugs had the same efficacy; pramipexole had significantly lower incidences of side effects such as nausea, vomiting and dizziness.
Dosage
According to Dr. Ray Sahelian, M.D., dopamine agonists such as pramipexole at a dosage of 0.125 mg and ropinirole at a dosage of 0.25 mg are useful in moderate to severe restless leg syndrome. Dr. Sahelian warns that long term use of dopamine-related medications may lead to worsening of symptoms in many individuals. With chronic use, people with RLS may begin to experience symptoms early in the evening then in the afternoon; the symptoms at night become more intense and begin to affect the arms or trunk.
Adverse Effects
Dopamine medications used in restless leg patients may have some adverse effects which include the development of impulsive or obsessive behaviors. According to a Mayo Clinic report published in "Neurology," compulsive gambling is one of the important adverse effects in RLS patients who are being treated with medications that stimulate dopamine receptors in the brain.
References
- PubMed Health: Restless Leg Syndrome
- Mayo Clinic: Restless Leg Syndrome: Cause
- "Mayo Clinic Proceedings"; An Algorithm for the Management of Restless Leg Syndrome; Michael H. Silber et al.; July 2004
- "Sleep Medicine"; Meta-analysis of the Efficacy and Tolerability of Pramipexole versus Ropinirole in the Treatment of Restless Legs Syndrome; S. Quilici; October 2008
- Dr. Ray Sahelian: Restless Leg Syndrome
