Restless legs syndrome—current therapies and management of augmentation

@article{Trenkwalder2015RestlessLS,
  title={Restless legs syndrome—current therapies and management of augmentation},
  author={Claudia Trenkwalder and Juliane Winkelmann and Yuichi Inoue and Walter Paulus},
  journal={Nature Reviews Neurology},
  year={2015},
  volume={11},
  pages={434-445}
}
Idiopathic restless legs syndrome (RLS) can severely affect quality of life and disturb sleep, so that pharmacological treatment is necessary, especially for elderly patients. [] Key Method In this Review, we summarize state-of-the-art therapies for RLS in the context of the diagnostic criteria and available guidelines, based on knowledge ranging from Class I evidence for the treatment of idiopathic RLS to Class IV evidence for the treatment of complications such as augmentation. We consider therapies…
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TLDR
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TLDR
The RLS augmentation with PPX treatment in Japanese patients was occurred at rate of 9.1%, being quite compatible with previously reported rates in Caucasian patients, supporting the importance of keeping doses of PPX low throughout the RLS treatment course to prevent augmentation.
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References

SHOWING 1-10 OF 146 REFERENCES
Treatment of Restless Legs Syndrome
  • C. Comella
  • Medicine, Psychology
    Neurotherapeutics
  • 2013
Restless legs syndrome (RLS) is a common disorder diagnosed by the clinical characteristics of restlessness in the legs associated often with abnormal sensations that start at rest and are improved
Methadone for refractory restless legs syndrome
  • W. Ondo
  • Medicine, Psychology
    Movement disorders : official journal of the Movement Disorder Society
  • 2005
TLDR
Methadone should be considered in RLS patients with an unsatisfactory dopaminergic response, and all patients who remain on methadone report at least a 75% reduction in symptoms, and none have developed augmentation.
Restless Legs Syndrome: Pathophysiology and Treatment
  • W. Ondo
  • Biology, Medicine
    Current Treatment Options in Neurology
  • 2014
TLDR
Dopamine agonists may most robustly improve pure urge to move and certainly periodic limb movements and Mu specific opioids also robustly improved RLS and are probably underutilized in severe cases.
Epidemiology, impact, and treatment options of restless legs syndrome in end-stage renal disease patients: an evidence-based review.
TLDR
Evidence so far shows that both approaches may be effective in terms of reducing the RLS symptom's severity; nevertheless, more research is needed on the efficiency of treatments for uremic RLS.
Augmentation of the restless legs syndrome with carbidopa/levodopa.
TLDR
A previously unreported but far more significant problem of markedly augmented RL symptoms occurred in the afternoon and the evening prior to taking the next nightly dose, and this augmentation was severe enough to require medication change for 50% of the RL patients and 13% of PLMS patients.
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