An Algorithm for the Management of Restless Legs Syndrome
Mayo Clinic ProceedingsPublished 1 July 2004
Michael H. Silber, Bruce L. Ehrenberg, Richard P. Allen, Mark J. Buchfuhrer, Christopher J. Earley, Wayne A. Hening
Citations304
SJR quartileQ1
SJR score2.00
SNIP2.28
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The role of carbidopa/levodopa, dopamine agonists, opioids, benzodiazepines, and anticonvulsants for the different types of the disorder is delineated.
Abstract
Restless legs syndrome (RLS) is a common disorder with a prevalence of 5% to 15%. Primary care physicians must become familiar with management of this disorder. This algorithm for the management of RLS was written by members of the Medical Advisory Board of the Restless Legs Syndrome Foundation and is based on scientific evidence and expert opinion. Restless legs syndrome is divided into intermittent, daily, and refractory types. Nonpharmacological approaches, including mental alerting activities, avoiding substances or medications that may exacerbate RLS, and addressing the possibility of iron deficiency, are discussed. The role of carbidopa/levodopa, dopamine agonists, opioids, benzodiazepines, and anticonvulsants for the different types of the disorder is delineated.
Keywords
MedicineNeuroscience
Sleep MedicineRestless legs syndrome: diagnostic criteria, special considerations, and epidemiology
2,877 Citations2003Richard P. Allen, Daniel L. Picchietti +4 more
Modification of the criteria for the diagnosis of restless legs syndrome is modified to better reflect that increased body of knowledge, as well as to clarify slight confusion with the wording of the original criteria.
Archives of Internal MedicineEpidemiology of Restless Legs Symptoms in Adults
766 Citations2000Barbara Phillips, Terry Young +4 more
The prevalence of restless legs in the general adult population is high and may be associated with decreased well-being, emphasizing the need for further research and greater medical recognition of this condition.
SLEEPRestless Legs Syndrome and Sleep Bruxism: Prevalence and Association Among Canadians
725 Citations1994Gilles Lavigne, Jacques Montplaisir
The data suggest that both sleep movement disorders can be concomitant and that socio-geographic and age characteristics influence the prevalence of reports.
NeurologyPrevalence and risk factors of RLS in an elderly population
658 Citations2000A. Rothdach, Claudia Trenkwalder +3 more
RLS is a frequent syndrome in the elderly with considerable impact on self-perceived mental health, affecting women about twice as often as men, and in women, the prevalence did not change with age, whereas men showed a nonsignificant inverse trend with increasing age.
Age and AgeingIron Status and Restless Legs Syndrome in the Elderly
487 Citations1994Shaun T. O’Keeffe, Kathleen M. Gavin +1 more
Iron deficiency, with or without anaemia, is an important contributor to the development of RLS in elderly patients, and iron supplements can produce a significant reduction in symptoms.
SLEEPIron and The Restless Legs Syndrome
467 Citations1998Erica R. Sun, Clara A. Chen +3 more
These data are consistent with those from a prior unblinded study and suggest that RLS patients will have fewer symptoms if they have ferritin levels greater than 50 mcg/l.
SLEEPAugmentation of the Restless Legs Syndrome With Carbidopa/Levodopa
446 Citations1996R.P. Allen, Christopher J. Earley
A previously unreported but far more significant problem of markedly augmented RL symptoms occurred in the afternoon and the evening prior to taking the next nightly dose, and this augmentation was severe enough to require medication change for 50% of the RL patients and 13% of PLMS patients.
NeurologyTreatment of restless legs syndrome with gabapentin
404 Citations2002Diego Garcı́a-Borreguero, Oscar Larrosa +4 more
A careful scrutiny of Table 2 suggests cause for concern, as six of the 23 cases (26%) reported malaise while taking gabapentin, compared with only two taking placebo, and the tripling of the rate of a serious condition is a concern.
SLEEPClinical Characteristics and Frequency of the Hereditary Restless Legs Syndrome in a Population of 300 Patients
361 Citations2000Juliane Winkelmann, Thomas C. Wetter +5 more
It is shown that patients with hereditary RLS may experience an earlier onset of the disease, compared to those of non-hereditary RLS, which was similar in both groups.
SLEEPThe Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder
326 Citations1999W. Hening, Richard R. Allen +4 more
A task force consisting of six authors reviewed the published literature on the therapy of the restless legs syndrome or periodic limb movements in sleep available in indices through April, 1998 and selected the 45 articles for detailed review which presented original investigations of therapeutic impact and met minimal standards.
SLEEPPractice Parameters for the Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder
291 Citations1999Andrew L. Chesson, Merrill S. Wise +6 more
These are the first clinical guidelines published for the treatment of Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder providing evidence-based practice parameters and dopaminergic agents are the best studied and most successful agents.
The American Journal of MedicineLong-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults
288 Citations1996Carlos H. Schenck, Mark W. Mahowald
Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep resulted in sustained efficacy in most cases, with low risk of dosage tolerance, adverse effects, or abuse.
PubMedRopinirole in the treatment of restless legs syndrome: results from the TREAT RLS 1 study, a 12 week, randomised, placebo controlled study in 10 European countries.
285 Citations2004Claudia Trenkwalder, Diego Garcı́a-Borreguero +7 more
SLEEPAn Update on the Dopaminergic Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder
273 Citations2004Wayne A. Hening, Richard P. Allen +3 more
The literature on levodopa, dopaminergic agonists (pergolide, pramipexoles, ropinirole, talipexole, cabergoline, piribidel, DHEC), and other dopamineergic agents (amantadine, selegiline) are reviewed.
PubMedRestless legs syndrome symptoms in primary care: a prevalence study.
218 Citations2003Deborah A. Nichols, Richard P. Allen +6 more
A high prevalence of RLS symptoms was observed in this primary care population and supports the need for heightened awareness in both the medical community and general population regarding this disorder, which can often be effectively treated within the primary care practice.
Sleep MedicineAugmentation and tolerance with long-term pramipexole treatment of restless legs syndrome (RLS)
216 Citations2003John W. Winkelman, Lindsay Johnston
Augmentation and tolerance are more common with extended pramipexole treatment of RLS than has been previously reported in preliminary studies, but these complications are generally manageable by earlier dosing or small dose increases of this agent, and only rarely require medication discontinuation.
SLEEPPergolide and Carbidopa/Levodopa Treatment of the Restless Legs Syndrome and Periodic Leg Movements in Sleep in a Consecutive Series of Patients
182 Citations1996Christopher J. Earley, Richard P. Allen
Pergolide provided a good treatment for the RL syndrome, particularly for the more severe RL cases without significant problems with RL augmentation, and the patients with PLMS respondedbest to carbidopa/levodopa, whereas severe RL patients responded best to pergolides.
SLEEPPramipexole in the Management of Restless Legs Syndrome: An Extended Study
142 Citations2003Michael H. Silber, M G Girish +1 more
Pramipexole was effective for RLS with continued response with time, partly due to additional doses prescribed for augmentation, and side effects were common, but generally mild and tolerated.
SLEEPMagnesium Therapy for Periodic Leg Movements-related Insomnia and Restless Legs Syndrome: An Open Pilot Study
109 Citations1998Magdolna Hornyak, Ulrich Voderholzer +3 more
It is indicated that magnesium treatment may be a useful alternative therapy in patients with mild or moderate RLS-or PLMS-related insomnia and further investigations regarding the role of magnesium in the pathophysiology of RLS and placebo-controlled studies need to be performed.
NeurologyRopinirole for restless legs syndrome
107 Citations2004Charles H. Adler, Robert A. Hauser +5 more
Ropinirole was effective and well tolerated for treating the symptoms of RLS and eight of the 22 patients had complete resolution of symptoms on ropinirole.
The Journal of Clinical PsychiatryBupropion SR Reduces Periodic Limb Movements Associated With Arousals From Sleep in Depressed Patients With Periodic Limb Movement Disorder
89 Citations2000Eric A. Nofzinger, Amy Fasiczka +2 more
Bupropion SR treatment reduces objective measures of PLMD in depressed patients with the disorder, and this results show that bupropion SR is not associated with antidepressant-induced PLMD.
SLEEPCabergoline is an Effective Single-drug Treatment for Restless Legs Syndrome: Clinical and Actigraphic Evaluation
39 Citations2003Marco Zucconi, Alessandro Oldani +2 more
Low doses of cabergoline showed effectiveness and safety in patients with moderate to severe RLS, with no appearance of augmentation phenomenon.
NeurologySafety of pramipexole in patients with restless legs syndrome
39 Citations2000Karin Stiasny, Jens Carsten Möller +1 more
In 1999, falling asleep at the wheel was reported as a new and worrisome side effect in eight patients with PD treated with nonergot dopamine agonists (DA) and its safety with particular regard to sleep attacks in patients with RLS was investigated.
PubMedRestless legs syndrome: diagnosis and treatment.
21 Citations2003V G P Kumar, Manvir Bhatia +3 more
RLS can be diagnosed purely on clinical criteria; and appropriate treatment results in significant relief; thus, the recognition of this entity is essential.