Open AccessMedication Tolerance and Augmentation in Restless Legs Syndrome: The Need for Drug Class Rotation
Author(s) -
Kurlan Roger,
Richard Irene Hegeman,
Deeley Cheryl
Publication year - 2006
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2006.00593.x
Subject(s) - restless legs syndrome , medicine , levodopa , dopaminergic , narcotic , pharmacotherapy , drug tolerance , drug , dopamine , physical medicine and rehabilitation , intensive care medicine , anesthesia , psychiatry , insomnia , disease , parkinson's disease
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.