Treatment of Restless Legs Syndrome

Restless legs syndrome (RLS) is one of the most common neurological disorders. It is characterised by an urge to move the legs accompanied by uncomfortable or unpleasant sensations. Symptoms occur predominantly at rest in the evening or at night, and they are alleviated by moving the affected extremity or by walking. Although the aetiopathogenesis of RLS is still unknown, the rapid and dramatic improvement of RLS with dopaminergic compounds suggests a dopaminergic system dysfunction as a basic mechanism. Some studies have shown that rotigotine transdermal patch is efficacious for RLS treatment: using dosages between 1 and 3mg/24 hours, up to >30% of severely affected patients became symptom-free. Similar safety and tolerability to other non-ergot dopamine agonists have been reported, except for skin reactions at the application site. One of the most important problems when treating RLS patients with dopaminergic compounds is augmentation, which is a phenomenon mainly characterised by earlier onset of symptoms. Retrospective evaluation of augmentation with rotigotine showed a value of 1.5% in a six-month placebo-controlled study and of 2.9% in a one-year open trial, which is lower than the percentage observed with the other dopamine agonist compounds with shorter half-lifes.