RESEARCH - Treatment of restless legs syndrome (Nerontin (gabapentin))

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Neurol Sci. 2007 Jan;28 Suppl 1:S61-6.

The treatment of restless legs syndrome.

Department of Neurological Sciences, University of Bologna Medical School,

Via Ugo Foscolo 7, I-40123, Bologna, Italy, pasquale.montagna@....

The objective was to provide an overview of the options for treatment of

primary restless legs syndrome (RLS), by analysing the relevant clinical

trials for RLS. The patients considered were those affected with primary (or

idiopathic) RLS. Levodopa, pramipexole, ropinirole, transdermal rotigotine,

pergolide and cabergoline all show clear evidence for efficacy in short-term

treatment. Adverse events with these drugs are those usual for dopaminergic

agents, and are usually mild and reversible, probably because of the

relatively low doses needed. Augmentation, i.e., worsening of RLS symptoms

not due to progression of the disease, however, represents a worrisome side

effect of dopaminergic drugs, especially levodopa. Ergot-derived

dopaminergic agents should also be periodically checked for the possible

development of multivalvular heart disease and pleuropulmonary fibrosis.

Gabapentin is another drug also having clear evidence for efficacy. In

conclusion, dopaminergic agents represent the first line of treatment for

idiopathic RLS.

PMID: 17235434

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=17235434

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Eur J Neurol. 2006 Oct;13(10):1049-65.

EFNS guidelines on management of restless legs syndrome and periodic limb

movement disorder in sleep.

Department of Neurological Sciences, University of Bologna Medical School,

Bologna, Italy.

In 2003, the EFNS Task Force was set up for putting forth guidelines for the

management of the Restless Legs Syndrome (RLS) and the Periodic Limb

Movement Disorder (PLMD). After determining the objectives for management

and the search strategy for primary and secondary RLS and for PLMD, a review

of the scientific literature up to 2004 was performed for the drug classes

and interventions employed in treatment (drugs acting on the adrenoreceptor,

antiepileptic drugs, benzodiazepines/hypnotics, dopaminergic agents,

opioids, other treatments). Previous guidelines were consulted. All trials

were analysed according to class of evidence, and recommendations formed

according to the 2004 EFNS criteria for rating. Dopaminergic agents came out

as having the best evidence for efficacy in primary RLS. Reported adverse

events were usually mild and reversible; augmentation was a feature with

dopaminergic agents. No controlled trials were available for RLS in children

and for RLS during pregnancy. The following level A recommendations can be

offered: for primary RLS, cabergoline, gabapentin, pergolide, ropinirole,

levodopa and rotigotine by transdermal delivery (the latter two for

short-term use) are effective in relieving the symptoms. Transdermal

oestradiol is ineffective for PLMD.

PMID: 16987157

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16987157

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