Treatment options for restless legs syndrome

Background: Restless legs syndrome (RLS) is a common condition characterized by dysesthesia and an urge to move. Predominantly, symptoms occur at rest in the evening or at night, and they are alleviated by moving the affected extremity or by walking. Although the etiopathogenesis of RLS is still unknown, the rapid and dramatic improvement of RLS with dopaminergic agents suggests that dopaminergic system dysfunction may be a basic mechanism. Dopaminergic agents are the best-studied agents, and are considered first-line treatment of RLS. Objective: To review all options for the treatment of RLS, including the non-pharmacological ones. Methods: The treatment suggestions are based on evidence from studies published in peer-reviewed journals, or upon a comprehensive review of the medical literature. Results/conclusion: Extensive data are available for levodopa and dopamine agonists, especially for pramipexole and ropinirole. Pharmacological treatment should be limited to those patients who suffer from clinically relevant RLS with impaired sleep quality or quality of life. A treatment on demand is a clinical need in RLS cases that present intermittent symptoms.