Taming the Tingles: Treatment for Restless Legs Syndrome

Patient Expert

Restless legs syndrome or Ekbom Syndrome affects hundreds of people night after night, keeping them and their partners awake. It can even lead to sleep deprivation.


What are the symptoms of restless legs syndrome? The itching, burning sensation on the limbs and the endless need to move them as the sufferer tries to find a comfortable position in which to lie. Often it's necessary to get up and pace the floor, take a hot/cold bath, anything to get rid of the misery in the legs.


What causes restless legs? The cause is unknown, although recent research suggests that a single unknown gene causes many of the cases. It is known that RLS is hereditary, with some families having several members suffering from the disorder. RLS is associated with iron deficiency, disorders of the peripheral nerve (e.g. neuropathy) and various other movement disorders (such as Parkinson's disease). However, the cause of RLS for most patients remains unknown.


How about treatment? Well, as mentioned above, walking will sometimes ease the misery as will a cold bath. Sometimes a hot bath is more soothing. The same goes for compresses.

Parkinson type drugs help, though why they work is not fully understood. Pramipexole, usually sold under the brand name Mirapex, is a new dopamine receptor agonist, a drug that binds to and activates dopamine receptors. Dopamine receptors are Cell-surface proteins that bind dopamine with high affinity and trigger intracellular changes influencing the behavior of cells. Ropinirole (Requip) is the only other medication approved by the US FDA for RLS. Other Parkinson's disease medications (such as L-dopa/carbidopa) may help, but long-term usage may possibly eventually worsen the symptoms.


Something new has been added to the mix. The above medications are all taken orally. New research, however, shows that taking the medication using a patch may be a better choice. Not only is it a simpler way - put the patch on and forget it - but it seems there are fewer side effects when using the patch. Still, the effectiveness and risks of the patch have not been compared against oral agents in head-to-head studies.


The treatments, including the patch may not work for everyone. Some side effects of Parkinson type drugs are nausea, vomiting, dizziness and drowsiness although many people tolerate the drug well. With the patch, the occurrence of these side effects may be reduced even further.


One curious side effect of these Parkinson's type drugs or dopamine agonists, as they are called, is impulsive behavior, including an urge to gamble. Researchers report that some patients taking these drugs for restless legs syndrome and Parkinson's are at risk of such behavior.

It's believed that, because these drugs stimulate the rewards functions of the brain, as well as movement, that the patient is stimulated to seek out pleasurable activities, including gambling.


For more information on restless legs syndrome, check out the Restless Legs Syndrome Foundation and the Facts Sheet from the National Institute of Neurological Diseases and Strokes.