Restless Legs Syndrome

MDNG PsychiatryDecember 2010
Volume 12
Issue 4

Online CME

Strategies for the Diagnosis and Treatment of Restless Legs Syndrome: A Practical Approach

Credits: 0.50

Fee: None

Expires: November 1, 2011

Multimedia: Audio/Slides

This CME program consists of three parts—“Strategies for the Diagnosis and Treatment of Restless Legs Syndrome: A Practical Approach,” “Strategies for the Clinical Identification and Diagnosis of Restless Legs Syndrome,” and “Treatment Strategies for Restless Legs Syndrome”—the feature discussions with experts in restless legs syndrome. Practical approaches to recognition of RLS, the impact of RLS on one’s quality of life, both pharmacologic and nonpharmacologic therapies, and strategies for overcoming augmentation are explored.


Poor Effect of Guideline Based Treatment of Restless Legs Syndrome in Clinical Practice

Journal: Journal of Neurology, Neurosurgery, and Psychiatry (September 30, 2010; online ahead of print)

Authors: Godau J, Spinnler N, Wevers AK, et al.

Purpose: “To prospectively assess the success of RLS treatment in the clinical setting and to evaluate potential demographic factors and comorbidities that may influence the response to therapy.”

Results: In both initially untreated and pretreated patients, no statistically significant improvements were seen in RLS symptoms or quality of life after 12 months of treatment based on RLS treatment guidelines from the German Neurological Society. Poor treatment was associated with the presence of neuropsychiatric comorbidity, including somatoform disorders (41% prevalence), chronic pain (32%), anxiety (20%), and major depression (16%). Thus, Godau and colleagues concluded that improve overall outcome in patients with RLS may be better achieved by targeting and treating neuropsychiatric comorbidity.

Prevalence and Disease Burden of Primary Restless Legs Syndrome: Results of a General Population Survey in the United States

Journal: Movement Disorders (November 10, 2010; online ahead of print)

Authors: Allen R, Bharmal M, Calloway M

Purpose: “To assess prevalence, disease burden, and costs of primary restless legs syndrome (RLS) in the US.”

Results: The use of validated diagnostic tools and exclusion of patients with medical conditions that are likely to cause RLS from a representative US panel “provide a very conservative estimate of US census-weighted prevalence of 2.4% for primary RLS and 1.5% for primary RLS sufferers.” Of respondents, roughly one-third had a physician diagnosis of RLS, with primary RLS sufferers experiencing a mean productivity loss of one day per week. “All RLS-related costs increased with RLS symptom severity, with increasingly significant decrements in health status, sleep disturbance, and work productivity.” Allen and colleagues concluded that even their “very conservative approach finds RLS in this cohort to be common, under-diagnosed, and carried a significant personal and social burden.”

Restless Legs Syndrome and Near-infrared Light: An Alternative Treatment Option

Journal: Physiotherapy Theory and Practice (October 26, 2010; online ahead of print)

Authors: Mitchell U, Myrer J, Johnson A, Hilton S

Purpose: To evaluate “the effectiveness of monochromatic near-infrared light treatment in decreasing symptoms associated with” restless legs syndrome (RLS), as few options are available for managing RLS, leaving new treatment options highly sought after.

Results: A steady decrease in RLS-associated symptoms was seen over four weeks in subjects who underwent 12 30-minute treatments to their lower legs with near-infrared light, leading to significantly greater improvement in these symptoms at treatment, and even four weeks following treatment, than seen in a control group, compared to baseline. “This new noninvasive method of treating RLS might become a valuable new management option,” wrote the authors, adding that more “research is needed to determine the mechanism(s) behind infrared light treatment and RLS.”

Clinical Trials

Suggested Immobilization Test for Early Detection of Restless Legs Syndrome Augmentation

Study Type:Observational

Age/Gender Requirement:18 years (male/female)

Sponsor:Johns Hopkins University

Purpose:To find a method for the early detection of medications that when taken for some time make the condition worse so that this problem can be either prevented or corrected.

Sleep Disorders Management, Health and Safety in Police

Study Type:Interventional

Age/Gender Requirement:18 years (male/female)

Sponsor:Centers for Disease Control and Prevention

Purpose:To “develop and test a sleep health detection and treatment program that we aim to apply nationwide to reduce police officer fatigue and stress; enhance the ability of officers and their families to cope with police work; improve the health, safety and performance of law enforcement officers; and thereby improve public safety.” Sleep disorders that will be examined include obstructive sleep apnea and restless legs syndrome.

The Educated PatientTM

Restless Legs SyndromeThe “Multiple Sclerosis” section at is written by Mayo Clinic staff and includes a great deal of information. Under the “Basics” tab, site visitors can read about symptoms, cause, risk factors, complications, preparing for a doctor appointment, tests and diagnosis, treatments and drugs, lifestyle and home remedies, and coping and support. Patients can click the “In-Depth” tab to learn about polysomnography, including what to expect and how to interpret results of the test.

Restless Legs Syndrome Fact Sheet

The National Institute of Neurological Disorders and Stroke offers this resource (updated less than a month before writing), which provides in-depth answers to eight common questions about restless legs syndrome. Common signs and symptoms, causes, diagnosis, treatment, and prognosis are explained—as is done, be it in less detail, at other sites. But This site goes beyond that to discuss current research and provide information on where patients can learn more. The fact sheet is also available in Spanish.

Medical Websites

Restless Legs Syndrome: Differential Diagnosis and Management with Rotigotine

This full-length article from Neuropsychiatric Disease and Treatmentreviews the diagnostic criteria and differential diagnosis of restless legs syndrome (RLS) and the chemical and clinical characteristics of rotigotine in the management of RLS. Specifically, the three characteristics of sleep-related movement disorder on which the diagnosis of RLS is based (sensory, motor, and circadiain), conditions that mimick RLS based on motor restlessness or by an abnormal motor pattern at sleep onset or during sleep, conditions that mimick RLS based on their ability to cause leg pains or discomfort, and the management of RLS with rotigotine are explored.

Pharma Focus

Lyrica (pregabalin)

Online CME

Treatment of Restless Legs Syndrome with Pregabalin: A Double-blind, Placebo-controlled StudyCredits:0.50


Expires:June 8, 2013


This course from the American Academy of Neurology—available only to academy members or subscribers to Neurology—reviews the “efficacy and potential side effects of pregabalin for restless leg syndrome.”

Clinical Trials

Pregabalin in Idiopathic Restless Legs Syndrome Patients

Study Type:Interventional

Age/Gender Requirement:18 years (male/female)

Sponsor: Pfizer

Purpose:To “investigate the efficacy and tolerability of pregabalin in treating idiopathic RLS patients for up to 12 months.”

Polysomnography Study of Pregabalin and Pramipexole Versus Placebo in Patients with Restless Legs Syndrome and Associated Sleep Disturbance

Study Type:Interventional

Age/Gender Requirement:18 years (male/female)


Purpose: To “assess the efficacy and safety of pregabalin and pramipexole versus placebo in the treatment of restless legs syndrome and associated sleep disturbance.”

From the HCPLive Network

Restless Legs Syndrome: Finding Relief

Patients with restless legs syndrome often experience symptoms for years before receiving an accurate diagnosis. Pharmacists are in a unique position to probe patients for this condition, which negatively impacts health and quality of life.

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