Restless legs syndrome medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Medical Therapy
Overview
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
Medical Therapy
In patients with mild symptoms of restless legs syndrome, no treatment may be required, although all patients should be screened for iron deficiency.[1]
- Pharmacologic medical therapy is recommended among patients with persistent or moderate to severe symptoms of restless legs syndrome.[1]
- Pharmacologic medical therapies for restless legs syndrome include dopamine agonists, alpha-2-delta calcium channel ligands and opioids.[1]
- The treatment of restless legs syndrome must be individualized to each patient.[1]
- In patients with mild symptoms, no treatment is required.[1]
Treatment of restless legs syndrome
- Preferred regimen (1): pramipexole[2]
- Treatment with pramipexole is started at a dosage of 0.25 mg per day, and progressively increase until the optimal therapeutic effect is obtained.
- Preferred regimen (2): Ropinirole[3]
- It is important to take ropinirole prior to symptom onset.
- For daily RLS, ropinirole may be started at 0.25 mg per day at 2 hours before RLS symptom onset, and then increased by 0.25 mg every 2 to 3 days until symptom relief is achieved (Silber et al 2004). Starting dose should be individualized based on RLS severity and age.
- The effective dose for ropinirole is typically 2 mg or less.
- Some patients may require doses as high as 6 mg/day.
- Preferred regimen (3): Carbidopa/levodopa 25/100 mg PO daily at bedtime[1]
- Alternative regimen (1): Gabapentin 300–1200 mg daily about 1 h before bedtime.[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Comella CL (2014). "Treatment of restless legs syndrome". Neurotherapeutics. 11 (1): 177–87. doi:10.1007/s13311-013-0247-9. PMC 3899490. PMID 24363103.
- ↑ Montplaisir J, Denesle R, Petit D (2000). "Pramipexole in the treatment of restless legs syndrome: a follow-up study". Eur J Neurol. 7 Suppl 1: 27–31. PMID 11054156.
- ↑ Kushida CA (2006). "Ropinirole for the treatment of restless legs syndrome". Neuropsychiatr Dis Treat. 2 (4): 407–19. PMC 2671939. PMID 19412490.