Dopaminergic Drugs
Generally a good response (about 90% of patients will respond)
a good choice if need to avoid sedative medications or for daytime complaints which would preclude the use of sedatives.
Sinemet (Carbidopa/LevoDopa)
LevoDopa (L-Dopa), is a precursor drug
turns into dopamine in the brain
most often used for RLS is the 25 /100 strength.
30-60 minutes before bedtime. Up to 3 tablets before bedtime
will last about 3-4 hours.
For early morning awakenings, another half to one pill can be added
works better for nighttime RLS than on daytime RLS symptoms.
nausea - avoided often if the medication is taken with food
mental effects (confusion, hallucinations, dizziness),
dyskinesia (abnormal involuntary movements which occur with long term usage).
Rebound and augmentation in 50-80% of patients, so Sinemet is likely better for mild RLS,
Rebound occurs as the drug's action is wearing off
-> symptoms coming back even worse than they were before treatment.
Augmentation: the intensity of the RLS symptoms can increase,
can onset earlier and even spread to the upper limbs.
(it is rarely seen with 1-2 tablets a day).
Repreve (Ropinirole)
RLS sufferers will generally need between .25 mg and 1.5 mg per day
Interacts with the antibiotic Cipro (ciprofloxin). Slow increase in dose over several weeks