How is The Restless Legs Syndrome?
Although movement brings relief to patients with RLS, it is usually only temporary. However, RLS can be controlled if there is another condition that may contribute to the syndrome. Often, treating the associated medical condition, such as peripheral neuropathy or diabetes, relieve many symptoms. For patients with idiopathic RLS, treatment is directed toward relief of symptoms.
For those with mild to moderate symptoms, prevention is the key, and many physicians suggest changes in lifestyle and activities that are performed to reduce or eliminate symptoms. A decrease in the use of caffeine, alcohol and snuff can provide some relief. Doctors may suggest that some people take supplements to correct deficiencies in iron, folate, and magnesium. Studies have also shown that maintaining a regular sleep pattern, can reduce symptoms.
Some people, realizing that the symptoms of RLS are lower in the early hours of the morning, change their sleep routine. Others have found that a routine of moderate exercise helps them sleep better while other patients report that excessive exercise exacerbates their symptoms of RLS. Take a hot bath, massaging the legs or apply a heating pad or ice may help relieve symptoms in some patients. Although many patients find relief with these measures, these efforts rarely eliminate the symptoms completely.
Physicians also may suggest a variety of medications to treat RLS. Doctors usually choose between dopamine, benzodiazepines (central nervous system depressants), opioids, and anticonvulsants. It has been shown that dopaminergic agents, used primarily to treat Parkinson’s disease, reduce symptoms of RLS and PLMD and are considered the preferred initial treatment.
They have reported good results with short-term treatment using levodopa and carbidopa, although most patients eventually develop “enhancement”, which means that symptoms are reduced at night but start earlier in the day before. Dopamine agonists pergolide mesylate, pramipexole, ropinirole hydrochloride and can be effective in some patients and there is less likelihood of causing the increase.
Patients with mild or intermittent symptoms may be prescribed benzodiazepines (such as clonazepam and diazepam). These drugs help patients have a more restful sleep, but not completely relieve the symptoms of RLS and may cause daytime sleepiness. Because these depressants in some cases may induce or aggravate sleep apnea should not be used by people with this problem.
For more severe symptoms may be prescribed opioids such as codeine, propoxyphene, or oxycodone for its ability to promote relaxation and reduce pain. Side effects include dizziness, nausea, vomiting and risk of addiction.
Anticonvulsants such as carbamazepine and gabapentin are also useful for some patients, because they reduce sensory disturbances (the tickling sensation or deque something is slipping). Some of the possible side effects are dizziness, fatigue and sleep.
Unfortunately there is no single drug that is effective for all people with RLS. What can help a person can actually worsen the symptoms of another. In addition, medications taken regularly may lose their effect by the drugs must be changed periodically.
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