Newer Dopamine Agonists in the Treatment of Restless Legs Syndrome

OBJECTIVE:To review the use of newer dopamine agonists, pramipexole and ropinirole, in the treatment of restless legs syndrome (RLS).DATA SOURCES:Biomedical literature was accessed through MEDLINE (1990–June 2000); key terms included restless legs syndrome, pramipexole, ropinirole, and dopamine agonists. References cited in those articles were also evaluated.DATA SYNTHESIS:A number of small clinical studies of short duration have examined the use of pramipexole and ropinirole in the treatment of RLS. Patients treated with either agent demonstrated marked improvement in RLS symptoms with minimal adverse effects. Recent postmarketing surveillance of the use of these drugs for Parkinson's disease reported problems with daytime somnolence; thus, patients should be counseled appropriately.CONCLUSIONS:Although the published trials show promising results for efficacy of pramipexole and ropinirole in the treatment of RLS, they are subject to many limitations. At present, these agents can be considered a reasonable alternative after failure of traditional therapies for RLS, such as carbidopa/levodopa. The encouraging results underscore the need for a large, double-blind study comparing pramipexole and ropinirole with traditional agents.