Drugs for Restless Leg Syndrome

The National Heart Lung and Blood Institute had this piece on their website on some of the available drugs that are out there for RLS. Please note that they say these are for use when lifestyle and nondrug treatments are not working. I appreciate that comment, because drug companies would have you think that their drug is the only cure, for me this is responsible reporting by an institute.


Medicines can help relieve some symptoms of RLS. Doctors prescribe medicines to treat RLS in people:

  • With clearly defined symptoms
  • Whose symptoms cannot be controlled by lifestyle and nondrug treatments

No single medicine is helpful in all persons with RLS. It may take several changes in medicines and dosages to find the best approach. Sometimes, a medicine will work for a while and then stop working.

Some medicines may not be safe for pregnant women.

Always talk with your doctor before taking any medicines, even over-the-counter medicines.

Specific medicines

Medicines used to treat Parkinson’s disease also are used to treat RLS. Even though these medicines help reduce RLS symptoms, RLS is not a form of Parkinson’s disease. The medicines help reduce the amount of motion in the legs. They include:

  • Levodopa (le-vo-DO-pa)
    • Is best used to treat mild cases of RLS
    • Is short-acting
    • Works for a while but does not work long term in most people
  • Dopamine agonists (pergolide (PER-go-lid), pramipexole (prah-mih-PEX-ohl), and ropinirole (roh-PIN-ih-roll))
    • Are used to treat moderate and severe cases of RLS
    • Are used to treat mild cases of RLS if levodopa stops working
    • Are long-acting

The U.S. Food and Drug Administration recently approved ropinirole to treat moderate to severe RLS.

Other medicines may be used to treat RLS, including:

  • Strong pain-relieving medicines (narcotics).
    • Used most often when symptoms are severe
    • May be used in people who don’t respond to dopamine agonists
  • Sedatives (benzodiazepines (BEN-so-di-AZ-e-pens)).
    • Help with falling asleep
    • May cause daytime sleepiness
    • Are not recommended for people with sleep apnea and for older persons
  • Medicines used to treat epilepsy (anticonvulsants: gabapentin (gab-ah-PEN-tin), carbamazepine (kar-bam-AZ-e-pen), and valproate (val-PROH-ate)). These types of medicines are:
    • Considered when dopamine agonists fail
    • Most effective in persons with daytime and evening symptoms, as well as sleep-onset symptoms, and in those who describe the unpleasant feelings in the legs as painful.
  • Iron supplements, if iron deficiency appears to be contributing to RLS. Iron supplements should only be used if recommended by a doctor.


Sleep Habits that can Help

My summer schedule is always different than winter, especially my sleep habits. I go to bed later, usually not at the same time, and wake up later and at different times. My restless legs seem to act up more. So is there a correlation between keeping the same sleep schedule and RLS? We hear all the time how important it is to maintain a regular sleep schedule for good health but can it also make RLS worse? I was reading on the website for the National Heart Lung and Blood Institute and ran across these points on sleep and wanted to share them.

 Adopt good sleep habits:

  • Keep your bedroom or sleep area cool, quiet, comfortable, and free of unnecessary light.
  • Use your bedroom for sleeping, not for watching TV or using computers or cell phones.
  • Go to bed every night at the same time and wake up at the same time every morning. Some people with RLS find it helpful to go to bed later in the evening and get up later in the morning. The important thing is to get enough sleep so that you feel rested when you wake up.
  • Follow a program of moderate exercise

Other activities before bed that also may help relieve symptoms include:

  • Walking or stretching
  • Taking a hot or cold bath
  • Massaging the leg or arm
  • Using heat or ice packs

Good advice!


Restless Limbs Linked to Genes

This was posted by someone on one of the forums I visit and I felt it was worth repeating on my blog.

Restless limbs linked to genes
LEG TWITCHING: Two studies back the reality of the poorly understood syndrome.
By Mike Stobbe
The Associated Press
ATLANTA – Scientists have linked certain genes to restless legs syndrome, suggesting the twitching condition described as “jimmy lets” in a “Seinfeld” episode is biologically based and not an imaginary disorder.New studies published this week are being called the first to identify specific genes responsible for restless legs syndrome symptoms.

Research in the New England Journal of Medicine linked a common gene variation to nighttime leg-twitching. It involved people in Iceland and the United States.

A second study in Nature Genetics identified the same gene variation and two others in Germans and Canadians with restless legs syndrome.

“This discovery demonstrates the power of genetics not only for uncovering the biological causes of disease, but also for defining diseases such as RLS and establishing them as medical conditions,” said Dr. Kari Stefansson, who co-authored one of the studies.

RLS is characterized by a strong urge to move the legs. Sufferers say it often hits at night, keeping them from sleeping.

“It feels like something crawling inside your legs, biting on you,” said Betty Shaw, a 68 year old florist in Covington, Ga, who was diagnosed with it.

The condition gained cultural status in an episode of the sitcom “Seinfeld,” in which the character Kramer is disturbed that his girlfriend has “the jimmy legs” and kicks in bed.

The first study looked at blood samples from more than 1,000 Icelanders and Americans, comparing the DNA of leg twitchers to the DNA of people without the symptom. scientists found a certain variation in the human genome that, they say, probably accounts for 50 percent to restless legs cases.

The second compared the DNA of 400 people with a family history of the condition to the DNA of 1,600 others. It found variations in three areas of the genome that each were responsible for a 50 percent increase in the risk for the syndrome.

Here is the link to The New England Journal of Medicine article.