![]() BRAs are most effective in those with mild symptoms. BRAs such as zolpidem (Ambien®), eszopiclone (Lunesta®), and zaliplon (Sonata®) are shorter acting agents than clonazepam and may be equally effective. Clonazepam was the treatment of choice for RLS for many years but it is not clear that any one of this class of drugs is better than another for treating RLS. This receptor interacts with a larger GABA receptor.īenzodiazepine receptor agonists (BRAs) are newer drugs that do not have the benzodiazepine structure of the previous parent compound, but still bind to the benzodiazepine receptor. The structure of the parent compound was designated as a benzodiazepine, and later research identified a benzodiazepine receptor. This group of drugs is also known as sleeping pills and has valium-like effects. Presented by Christopher J.Earley, MB, BCh, PhD of the RLS Foundation Quality Care Center Director at Johns Hopkins Center for Restless Legs Syndrome. Tolerance to the opiates when treating RLS seems to be less of a problem than that seen with treatment of chronic pain disorders. It is important to realize that RLS for a majority of patients is not about pain it is an abnormal, uncomfortable sensation. The median starting dose for methadone in this study was 10 mg per day with a range between 2.5 mg and 20 mg per day. An analysis of drug responses in RLS over a 2 -10 year period showed that 85 percent of RLS patients who started on methadone were still on it compared to less than 20 percent of those started on a dopamine drug. This category of medications includes codeine, hydrocodone, oxycodone, morphine, hydromorphone, methadone, buprenorphine and pentazocine.Īn estimated 85 percent to 90 percent of patients with RLS will respond very well to opiates. Thus for over 300 years opiates remained the only truly effective treatment for this disease. Willis in his description of this disease in 1685 also reported on the benefits of opiates for treating the symptoms. Learn more about dopamine drugs and possible side effects. Excessive sleepiness, increased compulsive behavior and more commonly, augmentation, a paradoxical worsening of symptoms, may occur with these medications after extended use. These medications are likely to be effective in reducing symptoms in 90 percent of patients with restless legs syndrome. However, there is no indication that RLS is related to, or is a precursor of, Parkinson's disease. These drugs are also used for Parkinson's disease. The dopamine-related drugs include levodopa, pramipexole, ropinirole and rotigotine. Dopamine-Related Medicationsĭopamine is a chemical that is produced by certain cells in the brain and this group of drugs functions to either increase the amount of dopamine made by the cell (levodopa) or increase the dopamine signal to other surrounding cells by mimicking dopamine in the brain. At present, there is no one drug which works for everybody, but most individuals with restless legs syndrome will find some benefit and relief with the currently available medications for treating this disorder, which can be divided into several categories: dopamine-related medications, opiates, benzodiazepines receptor agonists (BRAs), alpha-2 delta medications and iron supplementation. Unfortunately, there is no known cure for restless legs syndrome.
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