Dopaminergic therapy first choice in patients with restless legs syndrome

Common among older adults, restless legs syndrome (RLS) is a condition characterised by paraesthesias and dysaesthesias of the legs, usually occurring in the evening. The course of the disorder is typically chronic and progressive. A diagnosis of RLS should be considered in any patient with chronic paraesthesias. Nevertheless, because patients may be slow to seek medical help and the condition is often secondary to another disorder, many patients remain misdiagnosed or undiagnosed for years. Marked improvement in symptoms can occur with dopaminergic therapy, including dopamine precursors (levodopa) or dopamine receptor agonists. Anticonvulsants, opioids and hypnosedatives may also be of benefit in some patients. As with all drug therapy administered to the elderly, dosages must be slowly and cautiously titrated to minimise the occurrence of adverse effects.