RESEARCH ARTICLE
Augmentation in Restless Legs Syndrome: Treatment with Gradual Medication Modification
Adam Rosenstein, Marcie Rabin , Roger Kurlan*
Article Information
Identifiers and Pagination:
Year: 2015Volume: 9
First Page: 4
Last Page: 6
Publisher ID: TONEUJ-9-4
DOI: 10.2174/1874205X01509010004
Article History:
Received Date: 10/1/2014Revision Received Date: 24/3/2014
Acceptance Date: 25/3/2014
Electronic publication date: 8/6/2015
Collection year: 2015

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/)
Abstract
Dopaminergic drugs can cause augmentation during the treatment of restless legs syndrome (RLS). We previously reported that sudden withdrawal of dopaminergic treatment was poorly tolerated. We now report our experience with gradual withdrawal of the dopaminergic drug during the drug substitution process using a retrospective chart review with comparison to previous data. Seven patients with RLS and dopaminergic drug-induced augmentation were treated with a gradual withdrawal of the offending drug and replacement with an alternative medication. Compared to sudden withdrawal, measured outcomes were similar but gradual tapering was better tolerated. We conclude that for augmentation in RLS, gradual tapering of the augmentation-inducing dopaminergic drug is better tolerated than sudden withdrawal. The optimal approach to treating augmentation has not been established and may differ between patients. Further study with direct comparison of strategies and a larger patient population is needed to confirm our preliminary observations.