What is the treatment for restless legs syndrome?

Restless legs syndrome is actually a relatively common disease among the elderly, as the incidence rate of restless legs syndrome in the elderly population can be as high as 10%. Symptoms of restless legs syndrome include paresthesias, numbness, and pain in the lower limbs. For the treatment of restless legs syndrome, in most cases, medication is used, which can only provide temporary relief.

Diagnostic criteria: The International Restless Legs Syndrome Study Group (IRLSSG) has developed a minimum diagnostic criteria consisting of four symptoms.

1. Abnormal sensation: Due to the indescribable discomfort in the limbs, there is a strong desire to move the limbs, mainly the lower limbs. These abnormal sensations often occur deep in the limbs rather than on the surface, such as the skin.

2. Motor symptoms: The patient cannot fall asleep and keeps moving his limbs to relieve abnormal sensations. The main symptoms are walking back and forth, shaking or flexing and stretching the lower limbs, or tossing and turning in bed.

3. Symptoms worsen during rest and can be temporarily relieved by activity.

4. Symptoms worsen at night and reach a peak late at night.

5. A very unpleasant physical sensation in the gastrocnemius muscle, often accompanied by temporary pain and itching in the leg.

6. Symptoms cannot be explained by medical or psychiatric disorders.

7. Other sleep disorders may exist.

treat

Dopaminergic drugs such as combined dopa preparations or dopa receptor agonists such as pramipexole or ropinirole are preferred. Compound dopa preparations are particularly suitable for patients who are preparing to take a long-distance flight or car trip. 70% to 90% of patients respond well to dopaminergic receptor agonists, so they are often the first choice, especially for those with more frequent attacks. Rotigotine patches have a sustained-release effect and may be a good choice for patients who also have daytime symptoms or those who have rebound in the early morning. Receptor agonists may have side effects such as nausea, drowsiness, headache, dizziness, hypotension, and external edema. Some patients may have symptoms of impulse control disorders such as pathological gambling, excessive shopping, and hypersexuality. In addition, anti-epileptic drugs such as gabapentin, carbamazepine, and pregabalin have certain therapeutic effects on some patients, and can be used or combined, especially when dopaminergic drugs are ineffective, ineffective, or have intolerable side effects. Other drugs, such as temazepam, clonazepam, and zolpidem, have certain effects on some patients. For patients with secondary restless legs syndrome, the first thing to do is to treat the primary disease. As the cause of the disease is eliminated, the patient's symptoms may also disappear. Such as kidney transplantation for patients with uremia, iron treatment for patients with iron deficiency anemia, folic acid supplementation for patients with folic acid deficiency, etc. For some severe and refractory patients, opioid drugs such as codeine, hydrocodone, methadone, oxycodone, tramadol, etc. can be used, which have a better effect on patients who are ineffective with dopaminergic receptor agonists. Some patients may experience constipation, urinary retention, drowsiness, and cognitive changes. In rare cases, opioids can cause respiratory depression, and large doses of opioids with a short half-life may lead to drug dependence.