People suffering from restless legs syndrome may find some relief by taking
one of several drugs approved to treat the condition, a new review confirms.
The medications, which include Requip (ropinirole), levodopa, Neurontin
(gabapentin) and Lyrica (pregabalin), appear to reduce symptoms of the syndrome
in more than 60% of patients, researchers report. The first two drugs raise
dopamine levels in the body, and the last two drugs reduce the amount of calcium
reaching brain cells and trigger the production of other chemicals that help
reduce pain. Dopamine is a brain chemical that regulates movement and mood.
"Physicians and patients now have better information on the effectiveness and
harms of two types of drug treatments for patients with at least moderately
severe restless legs symptoms in which to guide treatment choices," said review
author Dr Timothy Wilt, core investigator at the Minneapolis VA Health Care
What is restless legs?
Restless legs syndrome causes a person to feel a powerful urge to move his or
her legs. The legs become uncomfortable when lying down or sitting, and the
condition can disrupt sleep and take a toll on the quality of life, the
One expert, Dr Martin Niethammer, a neurologist at the Movement Disorders
Center of North Shore-LIJ's Cushing Neuroscience Institute in Manhasset, NY,
said this study is merely a review of the current treatments for restless legs
"There is nothing new here at all," he said. "It doesn't add anything to the
This is just a compilation of evidence that follows guidelines that have been
long established in both Europe and the United States, Niethammer said.
"These are the only treatments approved by the [US Food and Drug
Administration]," he added.
What the trials found
For the analysis, Wilt's team reviewed 29 clinical trials. The researchers
found that 61% of those taking dopamine agonists showed at least a 50%
improvement in their symptoms, compared with 41% of those taking an inactive
In addition, those taking dopamine agonists slept better and scored higher on
measures of quality of life. Dopamine agonists were originally developed to
treat Parkinson's disease.
Side effects of dopamine agonists can include euphoria, hallucinations,
weight loss, nausea, insomnia, tiredness or weakness, dizziness and
There are generic versions of Requip that cost far less, running between $11
and $22 a month. Insurance covers the treatment in most cases, so actual
out-of-pocket costs will vary by insurance plan. The same is true for levodopa,
Neurontin and Lyrica also helped relieve symptoms in 61% of patients,
compared with 37% of those taking a placebo, the researchers found.
The most common side effects of these drugs include fatigue, swelling in the
legs, dizziness and weight gain.
Without insurance, Lyrica costs can run more than $100 a month, but again
co-pays will vary by plan, Wilt said. The same is true for Neurontin, which can
cost $117 to $135 a month without insurance.
Treatments and medication
Wilt noted there is no information on the effectiveness of treatments in
pregnant women, young or old patients, those with milder symptoms or those with
other serious medical conditions. "We urge caution in extending our conclusions
to these individuals," he noted.
"Treatments for restless legs syndrome is now frequently advertised
direct-to-consumer, and thus while this may enhance awareness it may result in
patients seeking treatment for milder or other conditions not well-studied," he
The harms of medications may outweigh benefits for these individuals, Wilt
said. "Up to 25% to 50% with even moderate to severe and longstanding symptoms
stop taking these medications after more than a year due to either side effects
or lack of benefit," he noted.
Nonetheless, for people with moderate to severe restless legs syndrome
symptoms, these medications provided important benefits, at least in the short
term, Wilt said.
Patients should tell their doctors if they have bothersome sensations in
their legs that include distressing, irresistible urge to move them that is
relieved by rest, Wilt said.
"This may be due to restless legs syndrome or other conditions. An accurate
diagnosis is important. Effective treatments for restless legs syndrome are
available, and in patients with more severe symptoms may include medications,"
For more on restless legs syndrome, visit the US
National Library of Medicine.