TY - JOUR
T1 - Willis-ekbom disease foundation revised consensus statement on the management of restless legs syndrome
AU - Silber, Michael H.
AU - Becker, Philip M.
AU - Earley, Christopher
AU - Garcia-Borreguero, Diego
AU - Ondo, William G.
N1 - Funding Information:
To prepare the revised algorithm, the Willis-Ekbom Disease Foundation MAB established a task force from among its members who produced and revised a draft that was submitted for approval to the other members of the board. The authors have had many years of experience in the treatment of RLS and have conducted original research on this disorder. Some have been members of task forces that have produced the previously discussed evidence-based reviews. The effort was supported by the board of directors and executive director of the Willis-Ekbom Disease Foundation, but this article is entirely the unpaid work of the physicians and scientists on the MAB. It is based on detailed knowledge of the literature, including evidence-based assessments, and on expert opinion from practical experience. We recognize that a different group of specialists might have produced a somewhat different algorithm, but we believe that our approach reflects current thinking about the management of RLS/WED. We expect that the development of new medications and further research on existing ones may alter clinical approaches in the future. Of note, the US Food and Drug Administration has approved pramipexole, ropinirole, the rotigotine patch, and gabapentin enacarbil for the treatment of RLS/WED, and, thus, all other drugs discussed are being used off label. Although we have attempted to produce an accurate document, it is the responsibility of individual physicians to familiarize themselves with all aspects of the medications they prescribe and to decide whether a specific drug is appropriate for a particular patient.
PY - 2013/9
Y1 - 2013/9
N2 - Restless legs syndrome (RLS)/Willis-Ekbom disease (WED) is a common disorder, occurring at least twice a week and causing at least moderate distress in 1.5% to 2.7% of the population. It is important for primary care physicians to be familiar with this disorder and its management. Much has changed in its management since our previous algorithm was published in 2004, including the availability of several new drugs. This revised algorithm was written by members of the Medical Advisory Board of the Willis-Ekbom Disease Syndrome Foundation based on scientific evidence and expert opinion. It considers the management of RLS/ WED under intermittent RLS/WED, chronic persistent RLS/WED, and refractory RLS/WED. Nonpharmacological approaches, including mental alerting activities, avoiding substances or medications that may exacerbate RLS, and the role of iron supplementation, are outlined. Chronic persistent RLS/WED should be treated with either a nonergot dopamine agonist or a calciumchannel α-2-δ ligand. We discuss the available drugs, the factors determining which to use, and their adverse effects. We define refractory RLS/WED and describe management approaches, including combination therapy and the use of high-potency opioids.
AB - Restless legs syndrome (RLS)/Willis-Ekbom disease (WED) is a common disorder, occurring at least twice a week and causing at least moderate distress in 1.5% to 2.7% of the population. It is important for primary care physicians to be familiar with this disorder and its management. Much has changed in its management since our previous algorithm was published in 2004, including the availability of several new drugs. This revised algorithm was written by members of the Medical Advisory Board of the Willis-Ekbom Disease Syndrome Foundation based on scientific evidence and expert opinion. It considers the management of RLS/ WED under intermittent RLS/WED, chronic persistent RLS/WED, and refractory RLS/WED. Nonpharmacological approaches, including mental alerting activities, avoiding substances or medications that may exacerbate RLS, and the role of iron supplementation, are outlined. Chronic persistent RLS/WED should be treated with either a nonergot dopamine agonist or a calciumchannel α-2-δ ligand. We discuss the available drugs, the factors determining which to use, and their adverse effects. We define refractory RLS/WED and describe management approaches, including combination therapy and the use of high-potency opioids.
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U2 - 10.1016/j.mayocp.2013.06.016
DO - 10.1016/j.mayocp.2013.06.016
M3 - Article
C2 - 24001490
AN - SCOPUS:84884617766
SN - 0025-6196
VL - 88
SP - 977
EP - 986
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 9
ER -