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Medication Tolerance and Augmentation in Restless Legs Syndrome: The Need for Drug Class Rotation

  1. Roger Kurlan MD,
  2. Irene Hegeman Richard MD,
  3. Cheryl Deeley RNP

Article first published online: 8 NOV 2006

DOI: 10.1111/j.1525-1497.2006.00593_1.x

Issue

Journal of General Internal Medicine

Journal of General Internal Medicine

Volume 21, Issue 12, page 1338, December 2006

Additional Information

How to Cite

Kurlan, R., Richard, I. H. and Deeley, C. (2006), Medication Tolerance and Augmentation in Restless Legs Syndrome: The Need for Drug Class Rotation. Journal of General Internal Medicine, 21: 1338. doi: 10.1111/j.1525-1497.2006.00593_1.x

Author Information

  1. Movement Disorders Unit, Department of Neurology, University of Rochester School of Medicine, Rochester, NY, USA.

*Address correspondence and requests for reprints to Dr. Richard: Mt. Hope Professional Building, 1351 Mt. Hope Avenue, Suite 100, Rochester, NY 14620 (e-mail: Irene_Richard@urmc.rochester.edu).

Publication History

  1. Issue published online: 8 NOV 2006
  2. Article first published online: 8 NOV 2006

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Keywords:

  • restless legs syndrome;
  • levodopa;
  • dopamine agonists;
  • analgesics;
  • benzodiapezines

Restless legs syndrome (RLS) is a common condition characterized by an unpleasant urge to move the legs that usually occurs at night and may interfere with sleep. The medications used most commonly to treat RLS include dopaminergic drugs (levodopa, dopamine agonists), benzodiazepines, and narcotic analgesics. We report the cases of 2 patients with RLS who illustrate the problems of tolerance (declining response over time) and augmentation (a worsening of symptoms due to ongoing treatment) that can complicate the pharmacotherapy of RLS. We discuss the optimal management of RLS and propose strategies to overcome tolerance and augmentation such as a rotational approach among agents from different classes.

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