Diseases and Conditions

Restless legs syndrome

Treatment

Sometimes, treating an underlying condition, such as iron deficiency, greatly relieves symptoms of RLS. Correcting an iron deficiency may involve receiving iron supplementation orally or intravenously. However, take iron supplements only with medical supervision and after your doctor has checked your blood-iron level.

If you have RLS without an associated condition, treatment focuses on lifestyle changes. If those aren't effective, your doctor might prescribe medications.

Medications

Several prescription medications, most of which were developed to treat other diseases, are available to reduce the restlessness in your legs. These include:

  • Medications that increase dopamine in the brain. These medications affect levels of the chemical messenger dopamine in your brain. Ropinirole (Requip), rotigotine (Neupro) and pramipexole (Mirapex) are approved by the Food and Drug Administration for the treatment of moderate to severe RLS.

    Short-term side effects of these medications are usually mild and include nausea, lightheadedness and fatigue. However, they can also cause impulse control disorders, such as compulsive gambling, and daytime sleepiness.

  • Drugs affecting calcium channels. Certain medications, such as gabapentin (Neurontin, Gralise), gabapentin enacarbil (Horizant) and pregabalin (Lyrica), work for some people with RLS.
  • Opioids. Narcotic medications can relieve mild to severe symptoms, but they may be addicting if used in high doses. Some examples include tramadol (Ultram, ConZip), codeine, oxycodone (Oxycontin, Roxicodone, others) and hydrocodone (Hysingla ER, Zohydro ER).
  • Muscle relaxants and sleep medications. These drugs help you sleep better at night, but they don't eliminate the leg sensations, and they may cause daytime drowsiness. These medications are generally only used if no other treatment provides relief.

It may take several trials for you and your doctor to find the right medication or combination of medications that work best for you.

Caution about medications

Sometimes dopamine medications that have worked for a while to relieve your RLS become ineffective, or you notice your symptoms returning earlier in the day or involving your arms. This is called augmentation. Your doctor may substitute another medication to combat the problem.

Most drugs prescribed to treat RLS aren't recommended during pregnancy. Instead, your doctor may recommend self-care techniques to relieve symptoms. However, if the sensations are particularly bothersome during your last trimester, your doctor may approve the use of certain drugs.

Some medications may worsen symptoms of RLS. These include some antidepressants, some antipsychotic medications, some anti-nausea drugs, and some cold and allergy medications. Your doctor may recommend that you avoid these drugs, if possible. However, if you need to take these medications, talk to your doctor about adding drugs to help manage your RLS.