While there are many non-drug therapies that can help relieve symptoms of restless legs syndrome (RLS), medications may be an important part of the treatment strategy for individuals experiencing frequent or severe symptoms.

If you need to take medication, your physician will work with you through careful trials to find a drug and dosage that works best to manage your symptoms.

First Line Therapies

Current consensus treatment guidelines recommend:
Iron - Oral and Intravenous iron treatment indications
Alpha-2-Delta Ligands - gabapentin, gabapentin enacarbil or pregabalin

RLS Update Treatment

John Winkelman, MD, PhD explains the most current treatment guidelines and management strategies for RLS.

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Second Line Therapies

Although once considered a first line therapy, dopaminergic medications are now second line therapy due to augmentation. Augmentation is the worsening of RLS symptoms over time from drugs that act on the dopaminergic system. An estimated 5-10% of individuals taking dopaminergic medications experience new onset augmentation each year. Medications in this drug class include ropinirole, pramipexole and the rotigotine patch.

In addition, several drugs approved for treatment of other medical conditions have undergone clinical studies with RLS patients and provide symptom relief when used “off label.” Off label use is the prescribing of approved medications that show success in treating another medical condition other than its intended use, a practice permitted by FDA regulations. The 2021 Mayo Clinic Proceedings Article outlines the treatment algorithm for the care and management of the individual living with restless legs syndrome.


Medications 2016

Medications for RLS

Inside: Answers to commonly asked questions about medication options available to individuals with RLS.

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Understanding Drug Action

Understanding Drug Action

Inside: Medications are used to treat both acute illness and chronic diseases. Learn how drugs work and interact with foods.

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Drug Holiday

Drug Holiday and RLS

Inside: Learn more about the benefits and what to expect when discontinuing a therapeutic medication for a short period of time.

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Complementary and Alternative RLS Medications

Inside: Find out the alternative options available to help improve your sleep and well-being.

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What Is Augmentation?

Augmentation is defined as a worsening of RLS symptoms that occurs after starting a medication to treat RLS. The medication is effective when it is first started, but over time symptoms worsen with continued use of the medication. It is one of the most common but least understood problems encountered in the treatment of RLS.

Hear more about augmentation from expert physicians and members of the RLS community in our video below:









If augmentation occurs, you and your doctor can work together to find a new medication strategy that will work for you. Be sure to talk with your doctor before making changes to your regimen.