You were pretty sure you had it. Still, it was good to get the diagnosis. Are you looking for more restless legs syndrome info? Maybe cause, treatment? Here’s what you need to know…
Dopaminergic agents: These drugs, which increase dopamine in the brain, can reduce symptoms of RLS when taken at night.
You also know it doesn’t get the attention it deserves.
We started a two-part series on restless legs syndrome last week. In part one we defined it, reviewed its symptoms, and who’s more likely to have it.
Now it’s on to cause and treatment…
What causes restless legs syndrome
Like most of the conditions we discuss, the cause of restless legs syndrome (RLS) is unknown. That means we have to turn to triggers and scientific supposition to connect the dots.
If someone is experiencing RLS-like symptoms and any of the following are going on, the dots are connecting…
- Family history of RLS
- Parkinson’s disease/dopamine imbalance
- Sleep deprivation and other sleep conditions, such as sleep apnea
- Pregnancy or hormonal changes, especially in the last trimester
- Use of alcohol, nicotine, and caffeine
- Iron deficiency, even without anemia
- Using medications, such as some anti-nausea drugs, antidepressants that increase serotonin, antipsychotics, medications that contain older antihistamines
- End-stage renal disease and hemodialysis
What’s in the works?
Lots of mystery, supposition, and dot connecting going on when it comes to the cause of RLS. It’s terribly frustrating. But what can I say? It’s the brain.
The good news is the National Institute of Neurological Disorders and Stroke (NINDS) is funding a lot of fantastic research.
Included: investigating changes in the brain’s signaling pathways with an emphasis on dopamine, discovering genetic relationships, studying the role of endothelial cells in the regulation of cerebral iron metabolism, using advanced MRI to measure chemical changes in the brain’s arousal system, testing non-drug therapies, such as a non-invasive nerve stimulation device to use during sleep.
If you’re dealing with it, you know that’s the kind of attention RLS deserves.
How is restless legs syndrome treated?
There is no treatment that directly addresses RLS. So to secure relief we have to focus upon contributing medical conditions, lifestyle habits, and self-care.
Let’s start with medical conditions – reference the “triggers” above. Here are medications frequently used in the treatment of RLS…
- Iron supplements: Check with your physician first.
- Anti-seizure drugs (anticonvulsants): The first-line prescription drugs for those with RLS. The U.S. Food and Drug Administration (FDA) approved gabapentin enacarbil (Horizant, Regnite) for the treatment of moderate to severe RLS. Other anti-seizure drugs, such as pregabalin (Lyrica), can decrease sensory disturbances and nerve pain.
- Dopaminergic agents: These drugs, which increase dopamine in the brain, can reduce symptoms of RLS when taken at night. Ropinirole (Requip), pramipexole (Mirapex), and rotigotine (Neupro) are FDA-approved to treat moderate to severe RLS. Levodopa (L-Dopa) plus carbidopa (Lodosyn) may be effective, but can only be used intermittently.
- Opioids: Drugs such as methadone (Dolophine, Methadose), codeine, hydrocodone (Hysingla ER, Zohydro ER), or oxycodone (OxyContin, Roxicodone) are sometimes prescribed to treat individuals with more severe symptoms of RLS who do not respond well to other medications.
- Benzodiazepines: They are anticonvulsants. Medications such as clonazepam (Klonopin) and lorazepam (Ativan) are generally prescribed to treat anxiety, muscle spasms, and insomnia; and can help individuals get more restful sleep.
Lifestyle habits and self-care
Lifestyle habits and self-care have a major impact on distress. The following often provide relief for those with mild to moderate RLS…
- Avoid or decrease the use of alcohol, nicotine, and caffeine
- Change or maintain a regular sleep pattern
- Moderate, regular exercise
- Massage the legs or take a warm bath
- Apply a heating pad or ice pack
- Use foot wraps specially designed for people with RLS or vibration pads to the back of the legs
- Aerobic and leg-stretching exercises of moderate intensity
With creativity, we can come up with more.
The attention it deserves
That’ll do it for our series. Restless legs syndrome makes life challenging for tens of millions worldwide. If you or someone close to you has it, that isn’t front page news.
No cause, no cure. So quality management options will have to hold us over as research continues.
But there’s plenty of hope because restless legs syndrome is finally getting the attention it deserves.
To get the full scoop on restless legs syndrome, be sure to read part one.
For even more information and support, check in with the Restless Legs Syndrome Foundation.
Like our friend with his doc, if your interested in participating in a clinical trial for RLS, or any other disorder, start with NIH Clinical Trials and You. When you’re ready to find a trial, visit ClinicalTrials.gov.
Thanks to the following for the info: mayoclinic.org, University of Maryland Medical Center, National Institute of Neurological Disorders and Stroke
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Bill White is not a physician and provides this information for educational purposes only. Always contact your physician with questions and for advice and recommendations.