Restless Legs Syndrome

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Overview

Crawling, tingling, creeping, pulling, restless. These are common descriptions of Restless Legs Syndrome (RLS), which affects about 10% of the population. The uncomfortable sensations are accompanied by an almost irresistible urge to move the limbs, generally the legs. Traditionally underdiagnosed and undertreated, RLS may strike at any age, though it most commonly presents at around 50 to 60 years old and is twice as common in women as men. Beyond the discomfort, RLS can result in loss of sleep, depression, impaired quality of life, and substantial economic burden.

While the exact cause of RLS is still somewhat of a mystery, it appears that both dopamine and iron are involved and several treatment options are available. Community healthcare providers play an essential role in recognizing the signs of RLS, as well as underlying conditions and coexisting disorders that may contribute to its occurrence. This issue reviews the FDA approved treatments for RLS, medications used off-label for the condition, and non-drug strategies that can help reduce symptoms. Ways to reduce the adverse effects and complications of therapy are also summarized.

Publication Date: Jan-1-11
Expiration Date: Jan-1-14
CE Credit: 1.5 (.15 CEU)
Type of activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Lindy Wood Swain, PharmD, Fellow in Geriatrics, Department of Pharmacotherapy, College of Pharmacy, Washington State University/Elder Services, Spokane, WA.

Disclosure Statement

Dr. Lindy Wood Swain reports no financial or personal relationship with any commercial interesting producing, marketing, reselling, or distributing a product or service that appears in this issue.

Guest Editorial Advisor

Tami L. Remington, PharmD

Editorial and Review Board

Editor and CE Administrator Terry M. Baker, PharmD Associate Editor and CE Coordinator Tracy Farnen, PharmD Associate Editors James Chan, PharmD, PhD Pharmacy Quality and Outcomes Coordinator Kaiser Permanente Oakland, CA Associate Clinical Professor School of Pharmacy University of California San Francisco San Francisco, CA Ron Finley, RPh Lecturer Department of Clinical Pharmacy University of California San Francisco San Francisco, CA Associate Member of the UCSF Memory and Aging Center Alzheimer's Research Center Consultant Pharmacist to the Institute on Aging-On Lok Senior Health Institute on Aging Alzheimer's Day Care Center Angie S. Graham, PharmD Drug Information Coordinator Stanford Hospital and Clinics Stanford University Medical Center Stanford, CA Julio R. Lopez, PharmD, FCSHP Chief of Pharmacy Service VA Northern California Health Care System Adjunct Clinical Professor College of Pharmacy Touro University Vallejo, CA Assistant Clinical Professor School of Pharmacy University of California, San Francisco San Francisco, CA

Adjunct Professor Thomas J. Long School of Pharmacy University of the Pacific Stockton, CA Visiting Associate Professor and Lecturer Nursing School Samuel Merritt University Oakland, CA Pamela Mausner, MD Joshua J. Neumiller, PharmD, CDE, CGP, FASCP Assistant Professor Department of Pharmacotherapy College of Pharmacy Washington State University And Elder Services of Spokane Spokane, WA Candy Tsourounis, PharmD Professor of Clinical Pharmacy Medication Outcomes Center Department of Clinical Pharmacy School of Pharmacy University of California, San Francisco San Francisco, CA Senior Editorial Advisor Gerard Hatheway, PharmD, PhD Editorial Advisors Jocelyn Chan, PharmD Belinda M. Danielson, RPh Christopher M. DeSoto, PharmD Cynthia Chan Huang, PharmD, MBA Fred Plageman, PharmD Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners Emily K. Meuleman, RN, C, MS

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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Target Audience

This accredited program is targeted to pharmacists and nurses.

Exam and Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Educational Goals and Objectives

At the conclusion of this program, participants will be able to:

1. Describe the symptoms and diagnostic criteria of RLS, differentiating between types (primary and secondary) and among categories (intermittent, daily, and refractory).
2. Explain the potential role of iron in the pathophysiology of RLS and describe its role in treatment.
3. Discuss the role of levodopa, dopamine agonists, anticonvulsants, benzodiazepines, and opioids in the treatment of RLS.
4. Counsel patients regarding non-drug and drug therapy, including the appropriate use and safety of each medication class.