Karl A. Ekbom, a Swedish neurologist, coined the term for restless leg syndrome in the 1940s to describe motor disturbances of the limbs, mainly during rest. Patients with RLS report no pain, but they do have disturbances in sleep, discomfort while walking and stress. RLS can be treated and sometimes cured.
Frequency
According to Dr. Ali M. Bozorg of the University of South Florida's Department of Neurology, about 10 percent to 15 percent of the U.S. population has RLS. Females tend to get RLS about twice as much as men. Diagnosis may take up to 10-20 years after symptoms first appear because of misdiagnosis or lack of recognizing the symptoms as RLS. Although RLS may rarely occur in infancy, it usually strikes people in their 50s to 60s.
Treatment
Drug therapy mainly treats symptoms, as a "cure" is only possible in secondary disease. Patients who suffer RLS symptoms at least three nights a week should be evaluated for continuous pharmacologic treatment. Effective treatment may require a combination of drugs from different drug classifications. The most commonly used drugs in each classification are examined below.
Dopaminergic Agents
Dopaminergic agents help alleviate involuntary movements associated with RLS. Mirapex and Requip are used to treat patients with Parkinson's disease. Requip is used for moderate-to-severe RLS, beginning with small doses that are gradually increased over a few weeks.
Sinemet (Levodopa with carbidopa) treats both primary and secondary RLS. It is the preferred medication for patients with mild and occasional symptoms. It is not suited for use in patients with narrow-angle glaucoma or those who have used MAOI inhibitors (antidepressants) within the past 14 days.
Benzodiazepines
The benzo drugs have not been shown to reduce RLS symptoms; rather, they make it easier to fall asleep and avoid sleep disturbances. They may be used alone or in combination drugs. Klonopin (clonazepam), Restoril (temazepam), and Xanax (alprazolam) are commonly prescribed to help with sleep.
Opioids
Due to the risk of addiction, these drugs are mainly used in cases that involve significant pain to the patient. Low-potency opioids include codeine and propoxyphene (Darvon, Dolene). Higher-potency drugs include oxycodone hydrochloride (Roxicodone) and methadone hydrochloride (Dolophine).
Anticonvulsants
Anticonvulsants are being used more for moderate to severe RLS, especially in patients with neuropathy. Gabapentin (Neurontin) is often prescribed for patients experiencing pain and/or neuropathy.
Precautions
Many RLS drugs should not be given with other medications or with certain medical conditions. Take as prescribed, and do not alter or skip doses without consulting a health care provider. Monitor for adverse reactions such as hypersensitivity, itching or change in kidney function. Caution should be used in prescribing for children or pregnant women.
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