Bupropion and Restless Legs Syndrome: A Randomized Controlled Trial

Abstract

Introduction:Restless legs syndrome (RLS) is a common neurological disorder affecting 10% of the population. Most antidepressants exacerbate symptoms; however, correlational studies have noted symptom improvement with bupropion. The purpose of the current study was to examine whether, in a controlled study, bupropion would improve the symptoms of RLS, or at least not exacerbate them.Methods: This was a double-blinded, randomized controlled trial. Twenty-nine participants with moderate to severe RLS received 150 mg sustained-release bupropion once daily, and 31 control participants received a placebo. Participants were followed for 6 weeks and completed standardized tools, including the International Restless Legs Syndrome Study Group (IRLSSG) severity scale.Results: The primary outcome was change from baseline in IRLSSG severity score; lower scores were associated with improved symptoms. At 3 weeks, IRLSSG scores were 10.8 points lower in the bupropion group and 6.0 points lower in the placebo group (P ‫؍‬ .016). At 6 weeks, IRLSSG scores were10.4 points lower in the bupropion group and 7.6 points lower in the placebo group (P ‫؍‬ .108). Bupropion was more effective than placebo in the treatment of RLS at 3 weeks; however, this difference was not statistically significant at 6 weeks.Conclusions: The data from our study suggest that bupropion does not exacerbate the symptoms of RLS and may be a reasonable choice if an antidepressant is needed in individuals with RLS. Larger studies that include titration of bupropion should be considered to determine if bupropion is appropriate for primary treatment of RLS, particularly considering the lower cost and favorable side effect profile compared with currently recommended first-line dopamine agonists. (J Am Board Fam Med 2011;24: 422-428.)

Restless Legs Syndrome In Multiple Sclerosis Patients – Patient Experience Atlipik Special Hospital For Medical Rehabilitation

“…A higher use of antidepressants in the RLS positive group was recorded in the study by Manconi et al 5 , but no such diff erence was found in the study by Shaygannejad et al 14 . Considering that some antidepressants have the potential of causing RLS 23,24 , while others do not 23,25 , a diff erent medication regimen could explain, at least partly, the above mentioned diff erences among the studies.…”

Brazilian consensus on guidelines for diagnosis and treatment for restless legs syndrome

“…The statistical significance of the improvement of RLS severity score observed in the first 3 weeks of use not remained after 6 weeks, and there were no differences when compared to placebo 98 .…”

Guest Family Physician Commentaries

“…Treatment of concomitant depression with serotonin selective reuptake inhibitors may exacerbate restless leg symptoms. 6 This study by Bayard et al 7 examines this common problem that affects approximately 10% of our patients. It also addresses the quandary practitioners face when treating concomitant depression with an antidepressant.…”