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Salminen, A.V. ; Winkelmann, J.

Restless legs syndrome and other movement disorders of sleeptreatment update.

Curr. Treat. Options Neurol. 20:55 (2018)
Postprint DOI
Open Access Green
Purpose of reviewThe purpose of this review article is to summarize and discuss the recent advances in the treatment of restless legs syndrome (RLS), as well as REM sleep behavior disorder (RBD), and periodic leg movement disorder (PLMD).Recent findingsTraditionally, dopaminergic therapy has been considered the sole option for first-line treatment of RLS due to their impressive acute efficacy. Dopamine agonists such as oral pramipexole and ropinirole, as well as transdermal rotigotine are all effective treatment options. However, augmentation of the RLS symptoms is a major limitation of oral dopaminergic therapy. Recently, gabapentinoid agents such as gabapentin enacarbil and pregabalin have shown comparable short-term efficacy to dopaminergics with lower risk of augmentation of the RLS symptoms. Recent evidence on the efficacy of oxycodone-naloxone in treatment-resistant RLS provides an additional therapeutic avenue. The increasing understanding of the role of iron in RLS pathophysiology has led to new options in iron supplementation therapy in RLS, including treatment with ferric carboxymaltose.SummaryWith emerging evidence of augmentation being a side effect specific to dopaminergic treatment, gabapentinoids are considered a safer option as initial treatment. In severe refractory RLS, oxycodone-naloxone can be used. If iron stores are low, IV iron formulations should be the initial treatment choice. New treatment options are needed to address issues with current therapies.
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Publication type Article: Journal article
Document type Review
Corresponding Author
Keywords Restless Legs Syndrome ; Treatment ; Dopamine Agonist ; Gabapentinoid ; Opioid ; Rem Sleep Behavior Disorder; Placebo-controlled Trial; Randomized Controlled-trial; Sleep Behavior Disorder; Open-label Extension; Double-blind; Ferric Carboxymaltose; Ekbom Disease; Parallel-group; Dopaminergic Augmentation; Gabapentin Enacarbil
ISSN (print) / ISBN 1092-8480
e-ISSN 1534-3138
Journal Current treatment options in neurology
Quellenangaben Volume: 20, Issue: 12, Pages: , Article Number: 55 Supplement: ,
Publisher Current Science Inc.
Publishing Place Philadelphia, Pa.
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Neurogenomics (ING)