Restless legs syndrome—current therapies and management of augmentation

Treatment of restless legs syndrome (RLS) usually involves dopamine agonists, which are approved for treatment of RLS in most countries; α-2-δ ligands, such as gabapentin enacarbil and pregabalin, are also effectiveIn patients with RLS who have low levels of ferritin, iron supplementation should be the first-line therapyFor patients with severe RLS, opioids such as oxycodone–naloxone are an option as second-line therapy where they are approvedAugmentation is a major complication of long-term RLS therapy with dopaminergic agents, and is related to high doses of dopaminergicsInternational treatment guidelines recommend weighing the benefits against the risks for each drug class when initiating treatmentCombined treatment approaches are used on the basis of expert opinions, and are currently not evidenced-based