What are the IRLSSG guidelines for long-term pharmacologic treatment of restless legs syndrome (RLS)?

Updated: Feb 22, 2017
  • Author: Ali M Bozorg, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

A Task Force of the International Restless Legs Syndrome Study Group (IRLSSG) has developed evidence-based guidelines for long-term pharmacologic treatment of RLS. [32] The Task Force reviewed the results of 61 studies and arrived at the following conclusions with respect to available medications:

· Pregabalin - Effective for up to 1 year in treating RLS (evidence level, A).

· Pramipexole, ropinirole, and rotigotine - Effective for up to 6 months in treating RLS (evidence level, A)

· Gabapentin enacarbil (1 year), pramipexole (1 year), ropinirole (1 year), levodopa (2 years), and rotigotine (5 years) - Probably effective in treating RLS for durations ranging from 1 to 5 years (evidence level, B)

· Pergolide and cabergoline - Because of associated safety concerns, not to be used in treating RLS unless the benefits clearly outweigh the risks

The IRLSSG Task Force recommends either a dopamine-receptor agonist or an alpha2-delta calcium-channel ligand as first-line treatment therapy for RLS in most patients, with the choice of medication depending on symptom severity, cognitive status, history, and comorbid conditions. [32]


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