RLS Drug Side Effects

Restless legs syndrome (RLS) is a neurological condition characterized by unpleasant sensations in the legs, usually occurring when the sufferer is tired or at rest. The medications that are prescribed for RLS can have significant side effects.

Dopamine Agonists

• The primary class of medications prescribed for RLS are called dopamine agonists. A dopamine agonist stimulates receptors in the brain that would normally respond to the body's naturally produced dopamine. These drugs have been shown to have a high success rate for those with moderate to severe RLS.

  The risks of dopamine agonists can, for some patients, outweigh the benefits. The most common of these side effects are nausea and dizziness.

  A less common, but far more drastic, side effect of dopamine agonists is compulsive behavior. This most often manifests as compulsive gambling, though some have behaved in extreme ways around sex or eating, as well. A 2005 study at the Mayo Clinic included a woman with no history of gambling who lost more than a hundred thousand dollars once she went on a dopamine agonist. These side effects can take about nine months to present themselves.

  Dopamine agonists are successful for the majority of RLS sufferers, but even those who've had good experiences with them can be affected by one disturbing trend. This is a process called augmentation, in which the medication either ceases to be effective or, for a time, causes symptoms to worsen.

  Levodopa and carbidopa are in a slightly different class called dopamine precursors. The risk of augmentation is higher with these drugs.

Benzodiazepines

• Benzodiazepines are psychoactive medications that are used to treat anxiety and insomnia, among other ailments. They function by depressing the central nervous system. They are prescribed in some instances for RLS patients, particularly those who suffer from sleep difficulties resulting from the condition.

  Benzodiazepines cause sleepiness that often persists into the following day, creating a "dazed" sensation. They can also cause significant decrease in sex drive, and can increase the risk of falls in elderly patients. This class of drugs also has a high risk of dependency; care must be taken to regulate dosages.

Opioids

• Opioid drugs such as oxycodone and codeine are occasionally prescribed where RLS patients experience pain. These can produce side effects such as dizziness, nausea, and constipation. The biggest risk with opioids, however, is addiction.

Anticonvulsants

• Neurontin and other anticonvulsants can be helpful for RLS patients who experience crawling sensations or other highly uncomfortable feelings in their legs. Like other RLS drugs, these can cause dizziness and next-day drowsiness.

Iron Therapy

• Most RLS sufferers benefit from taking iron supplements to increase the levels of iron in the body. This is because iron is necessary for the utilization of dopamine. In some cases, boosting iron levels or relieving anemia may be all that's needed to completely eradicate RLS symptoms. For others, increasing iron provides only modest relief.

  Iron supplements typically cause constipation. Many doctors recommend pairing the medication with a stool softener.