Restless legs syndrome causes sensations in your legs that can be uncomfortable or painful. These sensations make you want to move your legs for relief. This condition can cause you to lose sleep and become exhausted. Some people have found that changes in their lifestyle or diet can relieve their symptoms of restless legs syndrome. For others, medication may help.
The nerve pathway in the brain that helps control voluntary movements may not work normally in people with restless legs syndrome. This pathway uses certain chemicals that keep your movements normal. It is believed that people with restless legs syndrome have changes in the normal function of these chemicals. These changes may cause the involuntary movement that is typical of restless legs syndrome. Certain drugs can help treat the symptoms of restless legs syndrome by acting like the chemicals in this pathway or by helping these chemicals function normally.
The drugs that are used first to treat restless legs syndrome most often include ropinirole, pramipexole, and rotigotine. The drug gabapentin enacarbil is also used, but usually only when the other drugs don’t provide relief.
Ropinirole, pramipexole, and rotigotine
How do they work?
Ropinirole, pramipexole, and rotigotine belong to the class of drugs called dopamine agonists. A drug class is a group of drugs that act in a similar way. Dopamine agonists are often the first drugs used as treatment for restless legs syndrome.
Dopamine agonists such as ropinirole, pramipexole, and rotigotine mimic the effects of a chemical called dopamine. Dopamine is one of the chemicals in the nerve pathway of the brain that controls voluntary movements. These drugs may help dopamine work better to control the symptoms of restless legs syndrome.
Dopamine agonists should be used for short-term treatment. Long-term use of these drugs may lead to symptoms that are more severe. These symptoms may last longer and happen in locations other than your legs.
What forms do they come in?
Ropinirole and pramipexole come in tablets that you take by mouth. Rotigotine comes in a patch that that you place on your skin.
Ropinirole is available as the brand-name drugs Requip and Requip XL. Pramipexole is available as the brand-name drugs Mirapex and Mirapex ER. Rotigotine is available as the brand-name drug Neupro.
Ropinirole and pramipexole are also available as generic drugs. Rotigotine is not.
What are the side effects?
Side effects of ropinirole, pramipexole, or rotigotine include impulsive behavior, drowsiness, changes in blood pressure or heart rate, and hallucinations. If you have an allergy to sulfites, you should not take rotigotine. You will most likely be allergic to it.
How does it work?
The chemical gamma-aminobutyric acid (GABA) is also in the nerve pathway of your brain that controls voluntary movements. GABA does not work normally in people with restless legs syndrome. The structure of the drug gabapentin enacarbil is very similar to GABA. However, the exact way that gabapentin enacarbil improves restless legs syndrome is not known.
Gabapentin enacarbil is a newer drug that has been studied less than the dopamine agonists. It may be used in people who do not respond to dopamine agonists or who can’t take them.
What form does it come in?
Gabapentin enacarbil is available as an extended-release oral tablet. It’s only available as the brand-name drug Horizant. It’s not available as a generic drug.
What are the side effects?
Common side effects of gabapentin enacarbil include drowsiness and dizziness. You should not drink alcohol if you take gabapentin enacarbil. Alcohol can increase the amount of the drug that stays in your body, which can increase the risk and severity of the side effects.
You have several drug options to treat your restless legs syndrome. However, these medications affect each person differently. It may be necessary to change medications several times before you find the one that works for you.
Talk with your doctor about your options to relieve the symptoms of your restless legs syndrome. Only your doctor knows your medical history and can help guide you to a drug that is right for you.