TY - JOUR
T1 - The Management of Restless Legs Syndrome
T2 - An Updated Algorithm
AU - Scientific and Medical Advisory Board of the Restless Legs Syndrome Foundation
AU - Silber, Michael H.
AU - Buchfuhrer, Mark J.
AU - Earley, Christopher J.
AU - Koo, Brian B.
AU - Manconi, Mauro
AU - Winkelman, John W.
AU - Becker, Phillip
AU - Berkowski, J. Andrew
AU - Clemens, Stefan
AU - Connor, James R.
AU - Ferré, Sergi
AU - Hensley, Jennifer G.
AU - Jones, Byron C.
AU - Karroum, Elias G.
AU - Koo, Brian
AU - Ondo, William
AU - Richards, Kathy
AU - Sharon, Denise
AU - Trotti, Lynn Marie
AU - Uhl, George
AU - Walters, Arthur S.
N1 - Publisher Copyright:
© 2021 Mayo Foundation for Medical Education and Research
PY - 2021/7
Y1 - 2021/7
N2 - Restless legs syndrome (RLS) is a common disorder. The population prevalence is 1.5% to 2.7% in a subgroup of patients having more severe RLS with symptoms occurring 2 or more times a week and causing at least moderate distress. It is important for primary care physicians to be familiar with the disorder and its management. Much has changed in the management of RLS since our previous revised algorithm was published in 2013. This updated algorithm was written by members of the Scientific and Medical Advisory Board of the RLS Foundation based on scientific evidence and expert opinion. A literature search was performed using PubMed identifying all articles on RLS from 2012 to 2020. The management of RLS is considered under the following headings: General Considerations; Intermittent RLS; Chronic Persistent RLS; Refractory RLS; Special Circumstances; and Alternative, Investigative, and Potential Future Therapies. Nonpharmacologic approaches, including mental alerting activities, avoidance of substances or medications that may exacerbate RLS, and oral and intravenous iron supplementation, are outlined. The choice of an alpha2-delta ligand as first-line therapy for chronic persistent RLS with dopamine agonists as a second-line option is explained. We discuss the available drugs, the factors determining which to use, and their adverse effects. We define refractory RLS and describe management approaches, including combination therapy and the use of high-potency opioids. Treatment of RLS in pregnancy and childhood is discussed.
AB - Restless legs syndrome (RLS) is a common disorder. The population prevalence is 1.5% to 2.7% in a subgroup of patients having more severe RLS with symptoms occurring 2 or more times a week and causing at least moderate distress. It is important for primary care physicians to be familiar with the disorder and its management. Much has changed in the management of RLS since our previous revised algorithm was published in 2013. This updated algorithm was written by members of the Scientific and Medical Advisory Board of the RLS Foundation based on scientific evidence and expert opinion. A literature search was performed using PubMed identifying all articles on RLS from 2012 to 2020. The management of RLS is considered under the following headings: General Considerations; Intermittent RLS; Chronic Persistent RLS; Refractory RLS; Special Circumstances; and Alternative, Investigative, and Potential Future Therapies. Nonpharmacologic approaches, including mental alerting activities, avoidance of substances or medications that may exacerbate RLS, and oral and intravenous iron supplementation, are outlined. The choice of an alpha2-delta ligand as first-line therapy for chronic persistent RLS with dopamine agonists as a second-line option is explained. We discuss the available drugs, the factors determining which to use, and their adverse effects. We define refractory RLS and describe management approaches, including combination therapy and the use of high-potency opioids. Treatment of RLS in pregnancy and childhood is discussed.
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U2 - 10.1016/j.mayocp.2020.12.026
DO - 10.1016/j.mayocp.2020.12.026
M3 - Review article
C2 - 34218864
AN - SCOPUS:85108788654
SN - 0025-6196
VL - 96
SP - 1921
EP - 1937
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 7
ER -