Evidence-Based Medicine in the Treatment of Restless Leg Syndrome
Nesrin H. YILMAZ1, F. Nazlı Durmaz ÇELİK2, M. Cenk AKBOSTANCI3
1Medipol Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, İstanbul, Türkiye
2Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, İstanbul, Türkiye
3Ankara Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Ankara, Türkiye
Keywords: Controlled trials; dopamin agonist; gabanentin enacarbil; pregabalin; restless legs syndrome.
Abstract
The efficacy of dopaminergic drugs is proven for the treatment of restless legs syndrome (RLS) with controlled clinical trials. Doses of 0.25-0.75 mg/day pramipexole, 0.25-4 mg/day ropinirole, and 1-3 mg/day rotigotine transdermal patch are effective. Pregabalin 50-300 mg/day and gabapentin enacarbil 300-2400 mg/day are as effective as the dopaminergic drugs for relieving the symptoms of RLS. Additionally, these do not cause augmentation, as it is common in the treatment with pramipexole and ropinirole. While pregabalin, gabapentin enacarbil and rotigotine are accepted to be the first-line treatment, pramipexole and ropinirole are in the secondline. Oxycodone and propoxyphene are the most effective drugs among opioids and can be an alternative for patients where treatment with the other drugs is insufficient. Although there is no evidence for clonazepam, experienced physicians have a positive opinion.