Abstract
Restless legs syndrome (RLS) is a chronic neurological disorder that interferes with rest and sleep. It has a wide spectrum of symptom severity, and treatment is started when symptoms become bothersome. Dopamine agonists and calcium channel apha-2-delta antagonists (gabapentin, gabapentin enacarbil and pregabalin) are first-line treatments; calcium channel alpha-2-deltas are preferred over dopamine agonists because they give less augmentation, a condition with symptom onset earlier in the day and intensification of RLS symptoms. Dopamine agonists can still be used as first-line therapy, but the dose should be kept as low as possible. Iron supplements are started when the serum ferritin concentration is ≤75 μg/L, or if the transferrin saturation is less than 20%. For severe or resistant RLS, a combined treatment approach can be effective. Augmentation can be very challenging to treat and lacks evidenced-based guidelines.
Original language | English (US) |
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Pages (from-to) | 444-452 |
Number of pages | 9 |
Journal | Practical Neurology |
Volume | 17 |
Issue number | 6 |
DOIs | |
State | Published - Dec 1 2017 |
Keywords
- augmentation
- dopamine agonist
- iron
- periodic limb movement disorder
- restless legs syndrome
ASJC Scopus subject areas
- Clinical Neurology