TREATMENT of rls
Some people have no choice but to take medication to manage their RLS. Learn more about these medications below.
MANAGING YOUR RLS WITH MEDICATION
There are a number of medications available that may help ease your RLS. The following is an overview of some of these. You should always speak to your doctor about any questions relating to medication.
Levodopa may be recommended if you only have symptoms occasionally. Continuous use of levodopa can make your symptoms worse. It’s therefore only taken once the patient feels the symptoms of RLS coming on.
Dopamine Agonists affect the brain's level of dopamine, a neurotransmitter that plays a critical role in the functioning of the central nervous system, and are usually recommended if you have more regular and/or serious symptoms. They include Ropinirole (Requip), Pramipexole (Mirapex) and Rotigotine. Dopamine Agonists can cause significant side-effects for some people. If you are taking a Dopamine Agonist or if you intend to, we strongly recommend you read the information on this link
Anticonvulsant medications are considered less potent than dopamine agonists and are an effective option in mild cases of RLS or for those unable to tolerate dopamine agonists. They are also useful for RLS patients who experience painful sensations. An example of an anticonvulsant is Gabapentin (Neurontin).
Opioids are pain relievers and are most often used for patients with severe cases of RLS who do not respond to other treatments. Examples include Codeine and Propoxyphene.
MEDICATIONS TO AVOID
A number of medications can make RLS worse. In particular, anti-nausea drugs and sedating antihistamines can block the brain’s dopamine receptors, increasing the symptoms of restless legs. Antidepressants that increase serotonin and antipsychotic medications can also aggravate the condition. Let your doctor know if your restless legs symptoms worsen after you take a new medication. A change in dosage or a change to a different medication may help. Below we have listed a number of medications which our forum users suggested made their RLS worse. Please note that this list is not exhaustive and while we have been advised that they have made RLS symtoms worse for some people, this may not be the case for you.
Cold and Flu remedies: Actifed, Avamys, Benadryl, Chlortrimeton, Comtrex, Contact, Corcidin, Dimetapp, Drixoral, Fluticasone, PediaCare,Piriton, Rhinolast, Sinutab, Sudafed, Tavist, TheraFlu, Triaminic, Tylenol (flu, cold, PM, allergy), Vicks.
Note that many cough syrups may contain antihistamines, especially if they are recommended for cold or flu symptoms. Always try to choose non-drowsy options.
Anti-depressants: Many people living with RLS also live with depression and consequently are prescribed anti-depression medication. RLS is also common in two conditions that often co-occur with depression: ADHD and PTSD. However some anti-depressants can actually make RLS symptoms worse. If you are prescribed anti-depressants and live with RLS, we recommend you monitor your RLS symptoms to see if your symptoms worsen after starting anti-depressant medication. If so, speak to your medical practitioner to see if you can be prescribed an alternative medication.
Selective Serotonin-Reuptake Inhibitors (SSRIs): Celexa (Citalopram), Cymbalta, Duloxetine, Effexor, Lexapro (Escitalopram), Paxil (Paroxetine), Prozac (Fluoxetine), Serzone, Venlafaxine and Zoloft (Sertraline).
Tricyclic medications: Ascendin (Amoxepine), Elavil (Amitriptyline), Etrafon (Perphenazine and Amitriptyline), Limbitrol (Chlordiazepoxide and Amitriptyline), Norpramin (Desipramine), Pamelor (Nortriptyline), Sinequan (Doxepin), Surmontil (Trimipramine), Triavil (Perphenazine and Amitriptyline), Tofranil (Imipramine), Mirtazapine, and Vivactil (Protriptyline) , as well as others, have been suggested as making the symptoms of RLS worse.
Antacids: Medications to treat nausea can worsen RLS symptoms. This class of drugs includes: Anitvert, Atarax, Benadryl, Bonine, Compazine, Phenergan, Thorazine, Tigan, Trilafon and Vistaril, Zantac.
COMMONLY PRESCRIBED RLS MEDICATIONS
Some of the most frequently prescribed RLS medications are listed below, accompanied by details of the recommended starting and maximum daily dosage, how long it takes for a dose to become fully effective, the expected half-life of the drug (how long a drug takes to lose half its strength) and possible side-effects. We would like to thank our friends at King's College Hospital, London, for providing this chart to us.
Please note that the following is an overview and does not capture every medication used to treat RLS. You may also find that the amount you are prescribed differs from the doses suggested below. These details are for information only but we hope they will help you in making informed decisions with your GP.