by Bradley Gillespie, PharmD
In April 2013, a research team from the Minneapolis Veterans’ Affairs Medical Center published a review in the Journal of the American Medical Association (Internal Medicine) evaluating the pros and cons of managing Restless Legs (RLS) using conventional, FDA-approved drugs. In order to complete their work, the team systematically gathered all available evidence from 29 peer-reviewed medical journal articles, describing well-controlled clinical studies of at least 4 weeks in duration.
The outcomes of interest were a clinically beneficial impact on the symptoms of RLS and related adverse events. As might be expected, in many cases the drugs worked, showing clinically important responses in patients receiving dopamine agonists [drugs like Requip (ropinirole) and Mirapex (pramipexole)]. Furthermore, evidence was found showing that other drugs, such as Neurontin (gabapentin) and Lyrica (pregablin) also were effective, compared with a sugar pill.
In this article, the authors reported adverse events to include nausea and vomiting in patients who received dopamine agonists. In the trials where patients received Lyrica or Neurontin, unsteadiness and dizziness were commonly reported.
The authors concluded by stating that, based on their review of clinical studies, pharmacological interventions can indeed alleviate some symptoms of RLS and improve sleep outcomes. However, they also stated that adverse effects and treatment withdrawals due to these adverse effects were common.
The tolerance issues associated with the use of conventional pharmacological therapy are an eye opener, a startling finding, suggesting that the gentler Calm Legs approach to helping alleviate the symptoms of RLS may be a better choice for many individuals.
Restless Legs sufferer Bradley Gillespie, PharmD, is trained as a clinical pharmacist and has practiced in an industrial setting for the past 20-plus years. Currently, he supports efforts at the National Institutes of Health to develop therapeutics for rare and neglected diseases. He remains a registered pharmacist and operates a medical writing business.