Comparison of the Efficacy of Gabapentin Versus Levodopa-C for the Treatment of Restless Legs Syndrome in End-Stage Renal Disease on Hemodialysis Patients

Abstract

Objective: We aimed to compare the efficacy of gabapentin and levodopa-c for the symptoms of restless leg syndrome in patients of end-stage renal disease (ESRD) undergoing maintenance hemodialysis therapy. Methods: In this observational, cross-sectional study, patients of ESRD on hemodialysis with restless leg syndrome were included after assessment of symptoms and quality of sleep before the treatment by completing two questionnaires: the International Restless Leg Syndrome Study Group (IRLSSG) questionnaire and the Pittsburgh Sleep Quality Index (PSQI) scale. They were randomly divided into two groups. One group was prescribed levodopa-c (110 mg) as a single dose two hours before bedtime for four weeks. The other group was given gabapentin (200 mg) after each hemodialysis session for four weeks. After the treatment, the patients completed the two questionnaires again: the IRLSSG questionnaire and the Pittsburgh Sleep Quality Index.Results: In our study, men were 14 (53.8%), and women were 12 (46.2%). Gabapentin was given to 14 (53.8%) patients, and 12 (46.2%) patients were prescribed levodopa-c. In the levodopa group, the average baseline IRLSS was 24.333 ± 7.936), and the mean baseline PSQI score was 13.583 ± 3.396. After treatment with levodopa for four weeks, the mean IRLSS was 8.666 ± 3.312, and the mean PSQI score was 4.666 ± 2.839; a P-value of 0.00001 was noted. While in the gabapentin group, the mean baseline IRLSS was 26.071 ± 7.936, and the mean baseline PSQI score was 14.857 ± 3.254. After treatment for four weeks with gabapentin, the mean IRLSS was 5.3571 ± 1.392, and the post-treatment average PSQI was 2.992 (SD: 0.916); a P-value of 0.00001 was noted.Conclusion: Both levodopa and gabapentin effectively relieve symptoms of restless leg syndrome and improve the quality of sleep and life in ESRD patients undergoing hemodialysis.

Comparison the effect of valerian and gabapentin on RLS and sleep quality in hemodialysis patients: A randomized clinical trial

“…However, after the second intervention, although the reduction in RLS score was higher in the gabapentin group, there were no statistically significant difference between the two groups. In this regard, the results of the study by Ali et al, who compared gabapentin with levodopa, in line with the present study, showed a greater effect of gabapentin on reducing the RLS score [16]. In the study by Garcia-Borreguero et al, the RLS score was improved in the group that took gabapentin compared to the placebo group [25] and consistent with the present study, gabapentin caused a more reduction in the RLS score.…”

“…This syndrome causes chronic insomnia and daytime sleepiness, and therefore affects the patients' quality sleep [14,15]. Patients with moderate to severe RLS may sleep less than 5 h at night [16].…”

Restless Leg Syndrome in Hemodialysis Patients

“…Also, in an observational study of 26 patients with RLS, both levodopa and gabapentin significantly enhanced RLS symptoms. However, gabapentin was better in improving the quality of sleep with fewer chances of rebounding and augmentation 133…”

“…However, gabapentin was better in improving the quality of sleep with fewer chances of rebounding and augmentation. 133 Dopaminergic Drugs: dopamine agonists are widely used for treating RLS symptoms. The only dopaminergic drugs approved by the FDA include ropinirole, pramipexole, and rotigotine.…”

Pharmacological and non-pharmacological treatments for restless legs syndrome in end-stage kidney disease: a systematic review and component network meta-analysis

“…In the present study, gabapentin was the most effective pharmacological intervention in reducing RLS symptoms. The gabapentin dosage in the included studies was 100–300 mg after dialysis sessions [ 8 , 11 , 37 ]. Although the treatment dosage was within the recommended range, gabapentin-related adverse events and patient dropouts were still reported [ 37 ].…”