Restless legs syndrome , treatment

Restless-legs syndrome treatment involves suppression of abnormal sensations and leg movements and consolidation of sleep. Dopaminergic and sedative-hypnotic medications are prescribed commonly. 

Restless legs syndrome, also known as Ekbom s syndrome, causes unpleasant sensations in the legs such as tingling, discomfort and sometimes pain. Symptoms are usually worse at night and disturb sleep. Resting usually makes symptoms worse and activity relieves the condition. The cause of the condition is currently unknown but it is common and usually occurs in middle age. There are currently few treatments in place. 

FIGURE 38-1. Primary assessment and initial treatment for complaint of excessive daytime sleepiness. RLS, restless-legs syndrome NPSG, nocturnal polysomnography OSA, obstructive sleep apnea DA, dopamine agonist MSLT, multiple sleep latency test BZDRA, benzodiazepine receptor agonist SNRI, serotonin and norepinephrine reuptake inhibitor TCA, tricyclic antidepressant CPAP, continuous positive airway pressure. 

RDP respiratory disturbance index treatment of restless legs syndrome and periodic limb move-... 

One of the metabolites of bupropion, radafaxine (GW 353162, 25), is being studied as a treatment for obesity in clinic trials [76]. It is also reported to be in clinical development for restless leg syndrome, neuropathic pain, bipolar disorder and fibromyalgia [68]. 

The recent approval of the SNRI duloxetine for the treatment of diabetic neuropathy reinforces the utility of this drug class in the treatment of neuropathic pain. Other largely untapped areas which remain to be exploited with this drug class include sexual dysfunction, such as premature ejaculation, irritable bowel syndrome, obesity, neurodegenerative diseases such as Parkinson s disease, restless leg syndrome, and substance abuse and addiction. It is apparent that considerable opportunities for drug discovery will exist in this area for some time to come. 

Restless legs syndrome (RLS) Ropinirole is indicated for the treatment of moderate... 

Garcia-Borreguero D et al Augmentation as a treatment complication of restless legs syndrome Concept and management. Mov Disord 2007 22(Suppl 18) S476. 

Schapira AH Restless legs syndrome An update on treatment options. Drugs 2004 64 149. [PMID 14717617]... 

American Academy of Sleep Medicine (AASM) Report Standard of Practice Committee of the AASM Practice parameters for the treatment of restless leg syndrome and periodic limb movement disorder. Sleep 1999 22 961-968. 

Blom S, Ekbom KA (1961) Comparison between akathisia developing on treatment with phenothiazine derivatives and the restless legs syndrome. Acta Med Scartd 170 689-694... 

Staedt J, Hunerjager H, Ruther E, Stoppe G (1998) Pergolide treatment of choice in restless legs syndrome (RLS) and nocturnal myoclonus syndrome (NMS). Long term follow up on pergolide. J Neural Transm 105 265-268... 

Hening W, Allen R, Earley C, Kushida C, Picchietti D, Silber M (1999). The treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Review. Sleep 22 970-999... 

Earley CJ, Heckler D, Allen RP (2004) The treatment of restless legs syndrome with intravenous iron dextran. Sleep Med 5 231—235... 

Littner M, Kushida C, Anderson M, Bailey D, Berry R, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Li K et al. (2004) Practice parameters for the dopaminergic treatment of Restless Legs Syndrome and Periodic Leg Movement Disorder. An American Academy of Sleep Medicine report. Standard of Practice Committe of the American Academy of Sleep Medicine. Sleep 22 557-559... 

Happe S, Klosch G, Saletu B, Zeitlhofer J (2001) Treatment of idiopathic restless legs syndrome with gabapentin. Neurology 57 1717-1719... 

Wetter TC, Brunner J, Bronisch T. Restless legs syndrome 99. probably induced by risperidone treatment. Pharmacopsychiatry 2002 35(3) 109-11. 

Methadone 16 mg/day was effective in 29 patients with restless legs syndrome that had not responded to dopamine receptor agonists (9). Most (n = 17) were still taking methadone at follow-up and reported a 75% reduction in symptoms. Of 27 patients, 17 reported at least one adverse event while taking methadone, including constipation (n = 11), fatigue (n = 2), and insomnia, sedation, rash, reduced libido, confusion, and hypertension (one each). Five patients stopped treatment because of adverse events. 

Ferini-Strambi L. Restless legs syndrome augmentation and pramipexole treatment. Sleep Med 2002 3(Suppl) S23-5. 

Lauerma H, Markkula J. Treatment of restless legs syndrome with tramadol An open study. J Clin Psychiatry 1999 60 241-244. 

Stiasny K, Robbecke J, Schuler P, Oertel WH. Treatment of idiopathic restless legs syndrome (RLS) with the D2-agonist cabergoline An open clinical trial. Sleep 2000 23 349-354. 

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