Medications for RLS symptom management

Patients with primary RLS may work with their doctor to manage their symptoms with prescription medications. More than one type of medication may be prescribed, including dopaminergic agents and non-dopaminergic agents.1,2

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Augmentation: An RLS treatment challenge

Long-term use of a class of medications, known as dopaminergic mediciations, for RLS can cause augmentation, an increase in RLS severity after initial response to the medication.3

Classic features of RLS augmentation includes3,4:

  • Earlier onset of symptoms
  • Increase in symptom frequency or intensity
  • Symptoms spreading to previously unaffected body parts
  • Decrease in effectiveness of therapy

The risk that a patient may experience augmentation may increase the longer he or she uses these medications. Studies suggest that low iron levels, the length of therapy, and type of medication may be factors in the occurrence and rate of augmentation. Because augmentation can severely exacerbate symptoms and negatively impact quality of life, it should be evaluated by a healthcare provider and managed carefully.3

Screening for augmentation

In patients with worsening symptoms who have been on stable treatment for 6 months or more, the following questions may be used to help screen for augmentation4:

  • Do you experience RLS symptoms earlier in the day than when the drug was first started?
  • Do you now need higher doses of the drug compared with your original effective dose or need to take the medicine earlier in the day to control the RLS symptoms?
  • Have your symptoms gotten worse since you started the treatment?
  • Have your symptoms spread to other parts of your body, such as your arms, since you started the treatment?

If a patient answers affirmatively to 1 or more of these questions, augmentation should be considered.

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