Treatments and drugs

By Mayo Clinic Staff

Sometimes, treating an underlying condition, such as iron deficiency, greatly relieves symptoms of restless legs syndrome. Correcting an iron deficiency may involve taking iron supplements. However, take iron supplements only with medical supervision and after your doctor has checked your blood-iron level.

If you have RLS/WED without an associated condition, treatment focuses on lifestyle changes, and if those aren't effective, medications.

Medication therapy

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 reduce motion in your legs by affecting the level 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/WED.

    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) and pregabalin (Lyrica), work for some people with RLS/WED.
  • Opioids. Narcotic medications can relieve mild to severe symptoms, but they may be addicting if used in high doses. Some examples of these medications include codeine, oxycodone (Oxycontin, Roxicodone), combined oxycodone and acetaminophen (Percocet, Roxicet), and combined hydrocodone and acetaminophen (Norco).
  • Muscle relaxants and sleep medications. This class of medications, known as benzodiazepines, helps you sleep better at night, but they don't eliminate the leg sensations, and they may cause daytime drowsiness. Commonly used sedatives for RLS/WED include clonazepam (Klonopin), eszopiclone (Lunesta), temazepam (Restoril), zaleplon (Sonata) and zolpidem (Ambien).

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/WED become ineffective. Or you notice your symptoms returning earlier in the day. This is called augmentation. Your doctor may substitute another medication to combat the problem.

Most drugs prescribed to treat RLS/WED 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/WED. 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 medications, if possible. However, if you need to take these medications, talk to your doctor about adding drugs that to help manage your RLS/WED.

Dec. 10, 2014

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