Treatment options for RLS

Historically, there were a variety of treatments for RLS ranging from bloodletting to opiates. Indeed, Sir Thomas Willis over 325 years ago described the first probable case of RLS and used opium to alleviate the symptoms. When RLS was "rediscovered" by researchers in the 1980s, once again opioid narcotics were the treatment of choice (Hening WA, et al. 1986). In that study, five patients with RLS were given opioid drugs which relieved their awake RLS symptoms as well as PLMs and sleep disturbance. When counteracted with intravenous naloxone, the RLS symptoms and findings returned leading the authors to speculate on the endogenous opiate system playing a role in RLS pathogenesis. However, with increasing research in the last two decades, it has become clear that the underlying pathology of RLS is largely due to alternations in dopaminergic pathways. This has lead to the use of both nonspecific and specific dopamine receptor agents.

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