Question: What pharmacological or non pharmacological interventions are beneficial in managing restless leg syndrome?


Plain language summary

The research evidence presented suggests that dopamine medications are recommended as effective pharmacological treatments for Restless Leg Syndrome (RLS). However larger scale studies need to be conducted to establish which dopamine antagonist may be most effective. Further studies also need to be done comparing effectiveness and harms of other commonly used treatments, and with adults specifically within a mental health services population.

Clinical and research implications

There is evidence to suggest that the use of dopamine agonists can be recommended for the treatment of restless leg syndrome (RLS). This recommendation is based on three well-conducted systematic reviews (SR) that evaluated a number of good quality trials comparing dopamine agonists with placebo. No definite implications, however, can be made regarding which dopamine agonist may be most effective, given the lack of large scale head-to-head trials. The evidence was in the general population and not specific to people with mental health conditions. 

For further research, the SR authors stated that; more trials evaluating iron and opioid therapy are needed; and more research into the comparative effectiveness and harms of other commonly used treatments, particularly those without FDA approval is also needed.  The SR of pramipexole recommended that studies with longer-term follow-up and comparing pramipexole with other dopamine agonists, anticonvulsants and levodopa are needed. The SR of iron therapy recommended that more research is needed into the effects of iron therapy, particularly the best route of delivery, in people with RLS.


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