RLS Drug Options
No one drug is effective for everyone with RLS. What may be helpful for some may worsen symptoms for another. Drugs taken regularly can lose their effect, making it necessary to change drugs.
Dopaminergics
Dopaminergic agents have shown to reduce RLS symptoms and PLMD and are considered the initial treatment of choice. Good short-term results of treatment with levodopa plus carbidopa have been reported, although most patients eventually will develop augmentation, meaning that symptoms are reduced at night but begin to develop earlier in the day than usual.
Dopamine agonists that may be effective in some and are less likely to cause augmentation include:
Benzodiazepines
Benzodiazepines such as clonazepam and diazepam are prescribed for patients who have mild or intermittent symptoms. They help patients obtain a more restful sleep but they do not fully alleviate symptoms and can cause daytime sleepiness. Because these drugs also may induce or aggravate sleep apnea, they should not be used in people with this condition.
Opioids
For severe symptoms, opioids are prescribed for their ability to induce relaxation and diminish pain. Opioids include:
Side effects include:
- dizziness
- nausea
- vomiting
- risk of addiction
Anticonvulsants
Anticonvulsants such as carbamazepine and gabapentin are useful for some patients, as they decrease the sensory disturbances. Side effects include:
- dizziness
- fatigue
- sleepiness
