Medications Used for the Treatment of Restless Legs Syndrome

Restless legs syndrome (RLS) is a common disorder, with an estimated prevalence of 7% in the general population in the US, and with 1.5–2.7% reporting severe symptoms. RLS is characterized by an irresistible urge to move one’s legs, usually occurring at rest or inactivity, during the evening/night, and relieved by movement. Periodic limb movements (PLMs) are associated with RLS in approximately 80% of cases but are not necessary for the diagnosis. RLS can occur as a primary disorder or may be related to other medical conditions such as chronic renal failure, peripheral neuropathy, venous insufficiency, Parkinson’s disease, and iron deficiency. Female gender, family history of RLS, and pregnancy increase the risk of developing RLS. Additionally, the use of caffeine, nicotine, dopamine antagonists, and psychotropics can exacerbate symptoms in some cases. Non-pharmacologic measures that may be helpful in patients with RLS include moderate physical activity, acupuncture and pneumatic compression. This chapter primarily discusses medications that are used to treat RLS. These medications include iron therapy, dopamine agonists, alpha-2-delta ligands, opioids, benzodiazepines and non-benzodiazepine benzodiazepine receptor agonists.