Restless Leg Syndrome medications (prescription of course) can be a tricky subject. We have tried all the self-help, lifestyle changes, and underlying cause remedies that we can. The symptoms still exist, sometimes continually throughout the day and night. Your condition has been evaluated as severe or very severe because there is much pain associated with the other bothersome symptoms of RLS. Now is the time to allow your physician to prescribe a medication for you.
There is a wide variety of medications for RLS which is why the world famous ‘trial and error’ process will need to take place. Your own individual type of RLS may not respond or you may have side effects from some medications. In condensed form, here is a list of prescription drugs used to treat RLS:
Dopaminergic Agents
Considered first-line therapies since they typically alleviate all major features associated with RLS. Dopaminergic agents have an inhibitory effect on abnormal movements by enhancing levels of the neurotransmitterdopamine, a naturally produced chemical that regulates the delivery of messages between nerve cells (neurons) in the central nervous system. Such medications include bromocriptine mesylate (Parlodel®)and pramipexole dihydrochloride (Mirapex®) and ropinirole hydrochloride (Requip(TM)).
Dopamine Precursors
Known as Carbidopa/levodopa is used to control movement in Parkinson’s patients. This combination is available as Sinemet®.
Nonergotoline Dopamine Agonists and Other Medications
Best known by advertisements are ropinirole (Requip®) and pramipexole (Mirapex®).
Benzodiazepines
Interferes with chemical activity in the nervous system and brain, reduces communication between nerve cells. The benzodiazepine clonazepam (Klonopin®) is often prescribed for the treatment of RLS. Other benzodiazepines that may be recommended as appropriate, suitable alternatives include temazepam (Restoril®), diazepam (Valium®), and triazolam (Halcion®).
Opioids
Are natural or artificially produced (synthetic) chemicals that produce opium-like (opiate-like) effects. Opioid agents vary greatly in potency, ranging from mild to strong. Low-potency opioid agents may have beneficial results without risk of addiction, physicians may consider prescribing opioid agents such as propoxyphene hydrochloride (Darvon®) or codeine in patients with mild, periodic symptoms. The use of higher potency opioid agents such as oxycodone hydrochloride (Percocet® or Roxicodone®) or methadone hydrochloride should be reserved for those patients with severe RLS who have not responded to other appropriate medications.
Anticonvulsants
Is used to help manage or prevent episodes of abnormally increased electrical activity in the brain (seizures). Anticonvulsants may help relieve some symptoms associated with restless legs syndrome.carbamazepine (Tegretol®), a medication that reduces synaptic transmission, has been shown to decrease restlessness, sensory abnormalities, and sleep disturbances. However, it is thought that the medication may be less effective in reducing associated involuntary movements.
Gabapentin (Neurontin®) has shown promise as a potential treatment for individuals with RLS. Gabapentin seems to be most effective in those with mild or moderate RLS who experience actual leg pain. Alternatives including valproate (Depakene®), a medication derived from carboxylic acid, or lamotrigine (Lamictal®).
Other Medications
Clonidine hydrochloride (Catapres®) may alleviate leg discomfort and sleep difficulties in some people with RLS; but the medication may not be effective in reducing associated involuntary movements.
Additional Drug Treatments
Medications thought to relieve RLS symptoms, such as baclofen (Lioresal®), a muscle relaxant that is thought to block nerve activity in the spinal cord has been reported to control symptoms. No controlled studies have been evaluated on these medications as of yet. Large-scale clinical trials would be helpful in evaluating the use of such medications and assessing their long-term safety and effectiveness in the treatment of patients with restless legs syndrome.
Be aware that all of these Restless Leg Syndrome medications do come with side effects. The extent and duration of the side effects totally depends on which drug, which combination, and what dosage is given. Is it worth the agony to be on the medication? That will depend on how you react and how severe the impact of these medications and your Restless Leg Syndrome.
Chances are that you will need to try different medications and cross off your list the ones that don’t seem to work. Maybe even combinations of these medications. The best advice to handle this situation is to keep a journal documenting the prescriptions along with how you respond to these drugs. This is something that your physician will appreciate in adjusting or changing your medication.
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