Finding real relief from your RLS symptoms

If you're struggling with RLS, you're not alone. RLS is a serious condition that has a major impact on millions of people's lives. And although there's currently no cure, treatments are available to help manage RLS symptoms. Everyone has a different experience with RLS, so it's essential that you and your doctor work together to determine the most appropriate treatment for your RLS.1-3

When working with you to develop a treatment plan, your doctor may try a few different medications to find the one that best manages your symptoms.2

In this video, RLS expert and neurologist Daniel Lee, MD, discusses how RLS treatment should be tailored to each individual.

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RLS medications and supplements

If you are diagnosed with RLS, you should work with your doctor to find the treatment that works best for you. Some RLS treatments fall into the following categories:

  • Iron supplements: Patients with low iron levels may see improvement in symptoms from taking oral or intravenous iron supplements. All supplements should be taken under medical supervision.1
  • Prescription RLS Medications: Some treatments require a prescription from your doctor. These medicines are approved by the FDA to specifically treat RLS. The FDA reviews and approves drugs, ensuring that the medicines work and that the benefits outweigh their known risks. These medications are typically used for patients with moderate to severe symptoms.
  • Sleep medications: Benzodiazepines are a type of drug that can help patients sleep better, but they may not alleviate the leg sensations.1
  • Opioid pain relievers: Opioids are pain medications used to relieve RLS symptoms when first-line therapies are no longer effective, augmentation of unwanted side effects have occurred.1

Long-term side effects of RLS medications

Medication to treat RLS can have side effects, so it's important to talk to your doctor about the risks and benefits of any potential treatment when deciding if it's right for you. If you experience any unusual side effects during treatment, talk to your doctor immediately.4

Do not stop taking your medicine or change your dose without first talking to your doctor.

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What is augmentation?

You may have come across the word augmentation when researching RLS treatment. Augmentation is a potential long-term side effect of dopaminergic medications used to treat RLS. It refers to when a medication stops making RLS symptoms better and begins to make them worse.4

If you notice that your symptoms have gotten worse over time while you've been on treatment for RLS, ask your doctor about augmentation.

Signs of RLS augmentation

Imagine you start an RLS treatment that finally gives you some relief from your symptoms. But over time, your symptoms start to come back and intensify. The creepy-crawly sensations begin earlier in the day and start spreading to your arms and torso.4

If you've noticed your symptoms getting worse since starting a medication, you may be experiencing augmentation. Typically, augmentation will occur after being on a medication for
6 months or longer.5

Who is at risk for augmentation?

Augmentation is a potential side effect of dopaminergic medications that affect dopamine levels in the brain. An estimated 5% to 10% of people taking these medications develop augmentation each year. The cause is still unknown, but studies have shown that the longer you take a medication, the greater your risk of experiencing augmentation. Augmentation usually does not occur until you've been on a medication for at least 6 months.5

5 to 10 percent of people taking dopamine agonist medications develop augmentation

Being on a higher dose of medication may also increase your risk for augmentation. If your dose has been increased and your symptoms have gotten worse, ask your doctor about augmentation. Do not change your dose without talking to your doctor. Low stores of iron in the body are also a contributing factor in the development of augmentation.5

Diagnosing augmentation

There's no lab test for augmentation. Instead, your doctor will likely conduct a thorough medical history and physical exam to identify any other possible causes. There are several factors that can temporarily worsen RLS symptoms, including medications you may be taking (such as cold remedies or sleep aids, antidepressant medications, nausea medications), lifestyle changes (like changes in sleep habits, recent immobility or blood loss from surgery), and other conditions (such as iron deficiency).5,6

Neurologist Daniel Lee, MD, says he's seeing more and more patients with augmentation in his sleep lab. In this video, Dr. Lee talks about how doctors identify augmentation in patients.

At your appointment, be prepared to answer questions like the following:

  • 1. Do your RLS symptoms begin earlier in the day?
  • 2. Do they feel more intense?
  • 3. Have they spread to other parts of your body?
  • 4. How long has this been happening?
  • 5. Were your RLS symptoms previously being managed by this treatment?

It can be hard to remember details about your symptoms over several months, which is why keeping a symptom diary can be helpful.1

After ruling out other possible factors, determining that your medication was previously effective, and confirming that your symptoms have consistently worsened over time, your doctor will likely consider a diagnosis of augmentation.5

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