Sleep specialists normally treat RLS with a combination of
pharmacological treatments and behavioral advices. The Restless Legs
Foundation provides patient education and support.
Non-drug treatments for RLS
Iron and vitamin supplementation (especially if anemia or iron
deficiency), removing treatments that can make RLS worse (for example
neuroleptic, antihistamine, antidepressants), eliminating alcohol or
caffeine intake, exercise, walking, stretching, taking a hot or cold
bath, massaging, acupressure, or relaxation/mind engagement techniques.
Drug treatments for RLS
Dopaminergic agents (L-DOPA or Dopaminergic agonists drugs also used
for Parkinson's disease), gabapentin and opiates. Other sleeping aids,
anticonvulsants, and pain relievers may also be used. Treatment
duration varies and could require frequent adjustment of medications
to get the best response. Although dopaminergic stimulants such as
ropinirole (Requip) and pramipexole (Mirapex) are the only drugs
approved by the Food and Drug Administration (FDA) for the treatment
RLS, the other treatments are also effective. All these drugs may
produce side effects and must be prescribed by a doctor.
The decision to treat RLS should not be taken lightly, especially if
a Dopaminergic drug is prescribed, as chronic treatment with L-DOPA or
Dopaminergic agonists can lead to a worsening of RLS called
augmentation. If augmentation occurs, the usual dose of a dopaminergic
agent will relieve symptoms helping to sleep at night, but eventually,
the unpleasant sensations will develop earlier in the day.
Augmentation of RLS symptoms may occur after an initial period of
relief with dopaminergic agents, and unfortunately, increasing your
dosage will probably worsen your symptoms. Once augmentation has
occurred, it is difficult to stop the drug, as it typically
exacerbates the symptoms. If augmentation occurs, you and your doctor
must work together to find a new drug regimen that will work for you.