Restless legs syndrome: understanding its consequences and the need for better treatment

Restless legs syndrome (RLS) is a very common neurologic disorder with a prevalence of disease resulting in moderate and severe health impact of at least 2.7%. The purpose of this review, commissioned by the International Restless Legs Syndrome Study Group, was to assess the medical literature on the consequences of RLS and the limitations of existing therapies. We conclude that RLS affects quality of life at least as severely as other common chronic illnesses and in particular results in insomnia, anxiety and depression. Epidemiologic evidence suggests a relationship between RLS and cardiovascular disease. Dopaminergic medications are effective but their use is limited by adverse effects, especially augmentation and impulse control disorders. Other classes of medications have variable effectiveness, undesirable side effects and few large controlled trials. We recommend increased commitment to funding RLS research in both the pathophysiology of the disorder and its treatment. Future therapeutic trials for RLS should include measures of quality of life, mood and sleep. Drug regulatory agencies are urged to consider the prevalence and impact of RLS as well as the limitations of existing therapies in determining the risk-benefit ratio of new drugs submitted for possible approval.