Long-term Treatment of Restless Legs Syndrome With Dopamine Agonists

Abstract

Background: Controlled clinical trials robustly demonstrate the short-term efficacy of dopamine agonists (DA) for restless legs syndrome (RLS), but little is known about the long-term efficacy and long-term adverse events. Augmentation-an increase in the duration, intensity, and anatomy of RLS symptoms-is commonly associated with dopaminergic treatments; however, risk factors for this troubling scenario have not been formally evaluated. Objectives: To evaluate the long-term efficacy and tolerability of DA for RLS and to evaluate factors that could predict the occurrence of augmentation. Methods: We queried all subjects seen from 1996 to 2003 and followed up those initiated on any DA by the Baylor College of Medicine Movement Disorders Clinic, Houston, Tex. Patients with Parkinson disease, uremia, or medications that could affect RLS were excluded. Demographics, efficacy, dosing, adverse events, and augmentation were tracked across time. Statistical modeling was used to evaluate for factors that could predict augmentation.

A Case of Restless Legs Syndrome in the Setting of Long-Term Care and Dementia

“…These agents commonly result in an augmentation effect, with symptoms appearing earlier in the day and medication effectiveness decreasing over time [11,12]. This effect creates the challenging need to modify medications in residents who cannot communicate symptoms.…”

A Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Tolerability of Gabapentin Enacarbil in Subjects with Restless Legs Syndrome

“…In addition, some patients report worsening of symptoms over time, or experience intolerable side effects and longerterm complications such as augmentation, tolerance and impulse control disorders. 5,6 A non-dopaminergic alternative may benefit such patients. 7 Early reports indicate that gabapentin may provide effective treatment for RLS.…”

Restless Legs Syndrom bei Monozygoten und Dizygoten Zwillingen

“…Therapie der ersten Wahl bei täglich auftretendem mittlerem bis schwerem RLS stellen Dopaminagonisten dar Hening 2007 . Deutlich seltener und in milderer Ausprägung findet sich eine Augmentation bei der Therapie mit Dopaminagonisten Ondo et al 2004). Bei unzureichendem Behandlungserfolg oder Komplikationen durch die dopaminergen Medikamente (z.B.…”