The restless legs syndrome is typically caused by [sympathetic nervous system] stimulation, while no correlation exists between the presence of dopamine in the [nervous system] and the occurrence of restless legs syndrome. The present study highlights the significance of dopamine and sympathetic innervation in the sleep-wake cycle. The absence of dopamine in restless legs syndrome patients indicates an [parasympathetic nervous system] disorder, such as [nervous system] stimulation. Furthermore, the [nervous system] stimulation of restless legs syndrome patients is caused by the presence of dopamine. Patients suffering from restless legs syndrome can be treated using dopamine antagonist medications such as amineptine, pergolide, and ropinirole.
Given the broad spectrum of symptoms and associated behaviors, it is important to recognize RLS, because it can present with similar characteristics and manifestations as some other medical conditions. The diagnosis and treatment of RLS can improve the quality of life and symptom relief of the patient and is critical to the physician's practice.
Restless legs syndrome may be cured with pharmacological and psychological treatments. In most cases however, this effect is small and does not lead to a complete relief from the symptoms.
Around 7.1 million American adults have at least one symptom of restless legs syndrome, about as many as have chronic kidney disease. This suggests that there are several undetected cases of restless legs syndrome in the U.S. population.
Restless legs syndrome can present itself with a variety of clinical signs. Patient report can be unreliable and may not be specific for the diagnosis. A positive iron deficiency test appears to be the most specific finding, and may warrant further investigation. RLS may be an under-diagnosed disorder.
In a recent study, findings suggest that RLS can be adequately and sustainably treated with dopaminergic augmentation, although there is limited data available to support the use of dopamine agonists in managing non-compliant patients. The majority of patients treated with duloxetine also experienced subjective improvement; however, there were no statistically significant differences in RLS-specific outcomes between groups. Future investigations examining the efficacy and tolerability of duloxetine and other emerging dopamine-enhancing drugs are warranted.
The use of 600 mg horizant in combination with other treatments was the most common formulation prescribed in all study groups. A higher degree of tolerability was observed for 600 mg horizant than for placebo at all times and was not affected by the type of treatment being added. A larger, prospective, randomized study is needed to confirm these findings. The use of horizant 600 mg as a monotherapy in RLS appears promising, but long-term therapeutic effects requiring combination with other drugs and patients with comorbidities have yet to be adequately explored.
Because the RLS-inherited pattern of inheritance is not the same as that for the RLS phenotype itself, the genetic architecture of RLS appears to be substantially different from that of idiopathic RLS.
The placebo effect in RLS patients is large as was shown in a large sample meta-analysis: (a) placebo effect has not been adequately controlled in previous studies regarding RLS; (b) the placebo effect may be better controlled in studies of RLS compared to other disorders such as chronic heart failure; and (c) the placebo effect may explain the discrepancy between clinical trials and observational studies in regards to the efficacy of dopaminergic drugs in relieving RLS symptoms.
Findings from a recent study demonstrated that a single dose of 600 mg Horizant XR was efficacious in relieving the symptoms of restless legs syndrome and that there did not appear to be a need to reinforce the dosage of Horizant XR when symptoms recurred up to 10 hours after dose administration for up to 10 days of continuous treatment.
Restless legs syndrome occurs as an unexpected and temporary symptom in a large part of patients and its cause remains unknown. Restless legs syndrome is a condition that needs comprehensive medical and surgical management to achieve the optimum treatment result and to decrease the risk of recurrence. It is essential to recognize RLS in patients early on as a potentially serious condition and to have a detailed evaluation followed by adequate management.
Symptoms of RLS include: \n- Paresthesias\n- Restless (feeling) legs\n- Restlessness\n- Sleep disruption\n- Excessive sweating\n\nSide effects of horizant are similar to those of placebo. Side effects of horizant are common. Horizant may cause dizziness (dizziness is a side effect of other CNS depressants, and can be a symptom of drug overdoses or withdrawal.) Horizant may also cause hallucinations and delusions.