Dopamine agonists may be effective for restless legs

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Dopamine agonists may be effective for restless legs

Restless legs syndrome is defined as an urge to move legs often accompanied by uncomfortable and unpleasant sensations in the legs. Check ferritin and reverse iron deficiency first.

Tools for Practice1 reported on a systematic review on pramipexole. Dopamine agonists can be considered as first-line treatment for restless legs syndrome (RLS) but be aware of adverse effects such as augmentation (paradoxical increase in RLS symptom severity following initial symptom reduction), loss of impulse control, and drowsiness.

Initiate treatment with pramipexole; starting dose 0.25 mg, maximal dose 0.75 mg. The NNT is about 5. Ropinirole is another option, with a starting dose of 0.125 mg, maximal dose 4 mg orally once daily 2 hours before bedtime. These medications are also used in treating Parkinson’s Disease and both are funded in New Zealand.

Reference:

  1. A good sleep would be dop(aminergic) doc! Pramipexole in restless legs syndrome. Tools for Practice #275 (2020) View here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.