Pharmacologic Therapy for Primary Restless Legs Syndrome

Wilt, Timothy J; MacDonald, Roderick; Ouellette, Jeannine; Khawaja, Imran S.; Rutks, Indulis; Butler, Mary; Fink, Howard A

doi:10.1001/jamainternmed.2013.3733

Cited by 64 publications

(37 citation statements)

References 44 publications

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“…2 Most practitioners are unaware that antihistamines and antidepressants worsen RLS symptoms. 3 There are a few case reports of antihistamines causing agitation in adults. 4 The patient did not realize that adding more sedatives was counterproductive and causing her to be sedated during the daytime instead of helping her to sleep at night.…”

Section: Discussionmentioning

confidence: 99%

A 70-Year-Old Woman with Restless Legs Syndrome and Insomnia

Khawaja¹,

Jean-Noel²,

Shah³

2016

Psychiatric Annals

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Section: Discussionmentioning

confidence: 99%

A 70-Year-Old Woman with Restless Legs Syndrome and Insomnia

Khawaja¹,

Jean-Noel²,

Shah³

2016

Psychiatric Annals

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“…There are currently over 30 randomized, placebo-controlled studies and several published evidence-based reviews and meta-analyses of dopaminergic treatments for RLS [34,[69][70][71][72][73][74]. Overall, the direct dopamine agonists have been found to be effective in shortand longer-duration placebo-controlled studies for the treatment of RLS and PLMS.…”

Section: Dopamine Agonists For Rlsmentioning

confidence: 99%

“…Rotigotine is available as a transdermal patch, providing steady-state plasma levels over 24 h. With removal of the patch, the terminal half-life is 5-7 h. Rotigotine is metabolized in the liver, but requires no dose adjustment unless there is severely impaired liver function [75]. The rotigotine transdermal patch has been evaluated in 16 randomized, placebo-controlled studies and found to be effective for RLS symptoms [72]. Based on Class 1 evidence, rotigotine has been found to be effective for the treatment of RLS [69] at doses between 1 and 3 mg. An open-label study evaluated the effect the rotigotine patch over 5 years.…”

Section: Dopamine Agonists For Rlsmentioning

confidence: 99%

Treatment of Restless Legs Syndrome

Comella¹

2014

Neurotherapeutics

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Restless legs syndrome (RLS) is a common disorder diagnosed by the clinical characteristics of restlessness in the legs associated often with abnormal sensations that start at rest and are improved by activity, occurring with a diurnal pattern of worsened symptoms at night and improvement in the morning. RLS is the cause of impaired quality of life in those more severely afflicted. Treatment of RLS has undergone considerable change over the last few years. Several classes of medications have demonstrated efficacy, including the dopaminergic agents and the alpha-2-delta ligands. Levodopa was the first dopaminergic agent found to be successful. However, chronic use of levodopa is frequently associated with augmentation that is defined as an earlier occurrence of symptoms frequently associated with worsening severity and sometimes spread to other body areas. The direct dopamine agonists, including ropinirole, pramipexole, and rotigotine patch, are also effective, although side effects, including daytime sleepiness, impulse control disorders, and augmentation, may limit usefulness. The alpha-2-delta ligands, including gabapentin, gabapentin enacarbil, and pregabalin, are effective for RLS without known occurrence of augmentation or impulse control disorders, although sedation and dizziness can occur. Other agents, including the opioids and clonazepam do not have sufficient evidence to recommend them as treatment for RLS, although in an individual patient, they may provide benefit.

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“…The first description of the dopamine D 3 receptor subtype was in Sokoloff et al (1990). Meanwhile it has been described as an attractive target in several disorders like Parkinson´s disease (PD), restless legs syndrome (RLS), drug abuse, depression or schizophrenia (for reviews see: Blandini and Armentero, 2014;Brisch et al, 2014;Joyce, 2001;Leggio et al, 2013;Wilt et al, 2013). Furthermore a key role of especially peripheral dopaminergic receptors in hypertension was verified (for review see: Chugh et al, 2013;Zeng et al, 2007).…”

Section: Introductionmentioning

confidence: 99%