Diagnosis and Treatment of Augmentation Syndrome Secondary to Ropinirole: A Case Report

Augmentation refers to the exacerbation of restless legs syndrome (RLS) symptoms caused by prolonged use of dopaminergic medications. It is marked by an earlier onset of symptoms, spread of symptoms to the upper limbs, a shorter interval before symptoms reappear during rest, increased symptom severity, and a diminished response to medication, which may necessitate progressively higher doses and could potentially worsen the symptoms. In this patient, a 61-year-old Caucasian female with a 20-year history of RLS, treated with gabapentin 300 mg twice daily and ropinirole 0.25 mg three to four times per day, augmentation was observed, likely due to long-term treatment with the dopamine agonist ropinirole in combination with low vitamin D levels. This case highlights the importance of recognizing augmentation in patients on long-term dopaminergic therapy and considering contributory factors such as vitamin D deficiency. Early identification and individualized treatment adjustments are essential to improving outcomes.