We Know You Wish Your Restless Legs Would Let You Sleep

Unpleasant sensations from Restless Legs Syndrome (RLS) can occur while sitting still or during sleep, causing an irresistible urge to move.

What Is Restless Legs Syndrome?

RLS is also called Willis-Ekbom Disease. It is the most common movement disorder, characterized by an irresistible, often uncomfortable urge to move the legs when at rest.

You are not alone, RLS affects up to 10% of people in the U.S. Anyone can get it, but it is more common in women, and middle-aged people are more likely to have severe symptoms.

What Are Common Symptoms of Restless Legs?

At least 80 percent of people with RLS have a related condition called periodic limb movement of sleep (PLMS). PLMS causes the legs to twitch or jerk during sleep.

The pattern of movements with RLS is intermittent throughout the night. You might or might not notice your symptoms, but bed partners do tend to notice the excessive movements.

What Causes Restless Legs Syndrome?

Some people have primary RLS, which has no known cause. About 70% of people with RLS have primary RLS. Others have secondary RLS, which is typically associated with nerve problems, pregnancy, iron deficiency, or chronic kidney failure.

Pregnancy, particularly the last trimester, can be a trigger for RLS symptoms.

How Is Restless Legs Syndrome Diagnosed?

There are four key points doctors use to diagnose RLS. They can be described using the word URGE.

• Urge to move the legs—uncomfortable sensations that may be described as tingling, creeping, crawling, itching, or burning.
• Rest induced—the urge to move gets worse during inactivity such as resting, sitting, or lying down.
• Gets better with activity—movement such as walking or stretching brings relief, but unpleasant sensations reappear when you stop.
• Evening and night—the urge to move increases in the evening or at night or occurs only in the evening or at night.

How Is Restless Legs Syndrome Treated?

Lifestyle modification is the mainstay of treatment for people with mild or infrequent symptoms.

These steps include avoiding or decreasing the use of alcohol and tobacco, changing or maintaining a regular sleep pattern, a program of moderate exercise, yoga, massaging the legs, taking a warm bath, and using food wrap and vibration pad that is cleared by the U.S. Food & Drug Administration (FDA).

If you have moderate to severe RLS, your doctor will likely suggest one or more medications. Dopaminergic medications are typically a primary RLS treatment.

Medications That Increase Dopamine in The Brain

Most people know dopamine as a chemical in the brain that makes you feel happy. Dopamine is also used for coordinating body movements.

When dopamine is not available to the brain or nerves, it causes medical conditions including RLS, Parkinson’s disease (PD) and other diseases.

These medications affect levels of the chemical messenger dopamine in your brain. Ropinirole (Requip), rotigotine (Neupro) and pramipexole (Mirapex) are approved by the Food and Drug Administration for the treatment of moderate to severe RLS.

A patch may be right for you

The Neupro patch is a prescription medication, sold under the generic name Rotigotine Transdermal, that is applied to the skin and may be used to treat the symptoms of Parkinson’s disease and moderate to severe RLS.

As a so-called dopamine agonist, Neupro improves the function of these important cells.

The other medications, such as anticonvulsants, opioids, muscle relaxants, and sleep medications, do not completely eliminate symptoms, but they can help you relax and sleep better. 

How Can You Save On Your Prescription Neupro Patch?

As goodrx.com indicated that Rotigotine (Neupro) is an expensive medication used to control the signs and symptoms of Parkinson’s disease or restless legs syndrome.

There are currently no generic alternatives to Neupro. It is covered by more Medicare and insurance plans, but some pharmacy coupons or cash prices may be lower.

Cheapomeds.com carries brand Neupro patch manufactured by UCB pharm from Australia (Only $6.14 per patch – 4 mg).

You can save almost 80% by ordering from cheapomeds.com, which is certified by the CIPA (Canadian International Pharmacy Association).

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Does Quinine Help Restless Legs Syndrome?

Quinine has been used to treat muscle cramps since the 1930s. It was approved by the FDA for the treatment of malaria in August 2005.

Approximately 92% of Quinine use is associated with the off-label indication relating to the treatment of leg cramps and muscle pain.

On December 12, 2006, the FDA removed all the unapproved Quinine medications except the branded product – Qualaquin from the market and cautioned consumers about the off-label use of Quinine to treat leg cramps, because of the risk of serious side effects or death.

Despite the warnings, Quinine is still prescribed to individuals with muscle cramps of unknown origins. Some doctors do suggest a carefully monitored four- to six-week trial of quinine for patients whose leg cramps are not relieved by other means.

If your doctor does prescribe it for your RLS, and you decide to try Quinine, make sure that you are not at increased risk for serious side effects because of your health or other medications you may be taking (see cautions below). Also be aware that the appropriate dosage for leg cramps is unknown, though it is typically much lower than that recommended for the treatment of malaria (usually 200-300 mg at bedtime).

Cautions About Medications

Sometimes dopamine medications that have worked for a while to relieve your RLS become ineffective, or you notice your symptoms returning earlier in the day or involving your arms. This is called augmentation. Your doctor may substitute another medication to combat the problem.

Most medications prescribed to treat RLS are not recommended during pregnancy.

As for quinine, some of the more serious side effects that can result in hospitalization, serious illness, and death include thrombocytopenia, cardiac problems, rashes and other allergic reactions, thrombotic thrombocytopenic purpura—a rare, often fatal blood condition that causes clotting throughout the body, hearing problems, eye problems, electrolyte imbalance (the amount of minerals and fluids in the body), kidney failure and lung toxicity.

References:

• Mayoclinic.org
• Verywellhealth.com
• Goodrx.com
• Webmd.com
• Consumerreports.org
• Restedlegs.com
• Medscape.com