Restless legs syndrome (RLS) is a neurological disorder of the central nervous system, characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest and relieved by movement. The restlessness of the legs is often described as a burning or creeping sensation, sometimes compared to insects crawling inside the legs. Lying down and trying to relax worsens symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes daytime fatigue and sleep interruption.
Most causes of RLS are unknown, but a family history of the condition is seen in up to 50 percent of cases. RLS appears to be associated with specific risk factors:
1. Iron deficiency and anemia
2. Chronic diseases (ex. Kidney failure, diabetes, Parkinson’s)
3. Some medications, most commonly antidepressants and antinausea treatments.
The treatment for restlessness of the legs is directed toward the disease if identified. Most commonly, iron deficiency and some specific vitamin deficiencies should be corrected. Healthy sleep tips such as avoidance of caffeine, alcohol, and smoking could be very helpful.
Specific treatment with medications includes dopamine agonists medications such as Requip or Mirapex.
Sinemet is sometimes prescribed that carries the risk of worsening the disease.
Clonazepam may be used off label for the treatment of restless legs, it only carries significant risk for sedation and tolerance.
Horizant was approved in 2011 for the treatment of restlessness of the legs, it is the only non-dopamine agonist treatment approved. Horizant is a modified antiepileptic medication known as Neurontin, but with a specific formulation which allows for a better absorption and better activity onto restlessness of the legs.