If you find yourself tossing and turning at night because of restless leg syndrome (RLS), your doctor may be able to help. Medications are available to lessen the uncontrollable urge to move your legs due to the uncomfortable sensations of RLS. First, your doctor will rule out specific medical conditions that may cause symptoms similar to RLS, or make RLS symptoms worse, including diabetes, kidney disease, anemia and certain types of nerve damage. Checking for these conditions may involve a blood test, urine analysis or a neurological exam.
Blood tests may be used to measure iron levels in the body. Anemia and diseases that cause iron deficiencies have been associated with RLS, and supplementing your diet with iron, vitamin B12 or folate may help to relieve symptoms. But the use of some minerals can upset delicate chemical balances in the body, so mineral supplements should be used only under the direction of your doctor.
Your doctor will also ask what medications you are currently taking. Some drugs, including those used to treat high blood pressure, some heart conditions, nausea, colds, allergies, other sleep problems and depression can worsen the symptoms of RLS.
Prior to your physical exam, your doctor will ask you to describe your symptoms. He or she will ask when and how unpleasant sensations in your legs interfere with sleep and your daytime life. After other conditions have been excluded, a diagnosis of RLS ultimately rests on this discussion.
Currently, no medications are specifically approved for treating RLS, but doctors have a great deal of experience and success using medications that are approved for other purposes to help quiet your legs. There are four main classes of drugs that are believed to be effective:
Dopaminergic Agents
Drugs that are used to treat Parkinson's disease are often the first
ones prescribed in the treatment of RLS. These are called
dopaminergic receptor agonists, and they mimic the effects of the
neurotransmitter dopamine in the brain. It is believed that low
levels of dopamine in the body may induce RLS symptoms.
Sedatives
Sedatives can help patients suffering from mild RLS. Sometimes they
are used in addition to a dopaminergic agent.
Opioids
A group of drugs to relieve pain, called opioids, can be useful,
too. These drugs also promote relaxation. They are usually reserved
for severe cases of RLS.
Anticonvulsants
Anticonvulsants can be useful for some patients who have daytime
symptoms of RLS.
Whatever degree of RLS symptoms you have, it's important to talk with your doctor. Whether it is to recommend a change in lifestyle or to prescribe medicine, doctors can usually help RLS patients lead better, more rested lives.
Editor's Note:
People with low levels of iron in their blood often experience relief from RLS symptoms when they take iron supplements. Recent research suggests that iron is not absorbed normally in the brains of people with RLS. The theory is that iron is required to maintain normal levels of the brain chemical dopamine, and that insufficient dopamine levels leads to RLS symptoms. A group of medications called dopamine agonists is also used to treat RLS.
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