News
Tweaking the Treatment for Restless Legs
Last Super Bowl, a TV commercial lauded the power of Requip (ropinirole), the first drug approved to treat restless leg syndrome, a condition whose signature feature is creepy-crawly leg sensations that interfere with sleep and rest in nearly 1 of every 10 adults.
But if taken too long, the drug can actually backfire, causing symptoms of restless leg syndrome to worsen, say doctors who specialize in treating the condition. They say that treatment that rotates through different types of medications may be needed for many patients.
"It's impossible to tell the whole story in a TV spot just a few seconds long," said Irene Richard, M.D, a movement disorder neurologist at the University of Rochester Medical Center. "When patients come in asking about the treatment, doctors need to know that this is usually not a simple, single-pill solution, despite what they have seen on TV."
In an article published in the December issue of the Journal of General Internal Medicine, Richard and fellow neurologist Roger Kurlan, M.D., warn primary care physicians that they cannot expect long-term success by simply prescribing ropinirole or a similar medication in its class, which works by activating dopamine receptors in the brain. Instead, the team – experts at treating movement disorders like Parkinson's disease, Tourette's syndrome and restless leg syndrome – recommends that physicians may need to rotate some patients through these drugs along with different types of medications.
"The truth is, some of the most common, most effective drugs, including ropinirole and pramipexole, which was recently approved to treat restless leg syndrome, may only work effectively for each person for a limited time," Kurlan said. "After that, this class of drugs - albeit the most-popular, effective, and the only one approved by the Food and Drug Administration for restless leg syndrome - has a regrettable tendency to turn traitor. The medicine can actually begin to worsen symptoms."
In their paper, which was written together with nurse practitioner Cheryl Deeley, Richard and Kurlan examine the cases of two older women who have the syndrome. Typically, patients move their legs frequently and are often irked by a life of pacing in the wee morning hours, or in the worst cases, being unable to take road trips or even sit through a movie.