Epilepsy Drug Helps Restless Leg Syndrome
Less Limb Movement and Better Sleep on Gabapentin
Nov. 25, 2002 -- More than 12 million Americans suffer from restless leg syndrome, a little known neurological condition that in its most severe forms can result in chronic, life-altering sleep deprivation. Now new research suggests that a widely used epilepsy drug may give sufferers a better chance at a good night's sleep.
Restless leg syndrome (RLS) affects about 5-10% of the population and is characterized by an uncontrollable urge to move the legs and sometimes arms due to sensations ranging from annoying to painful. Patients commonly describe what they feel as tingling, twitching, pins and needles, prickly, aching, or throbbing. The symptoms can fluctuate with time and tend to progress with age.
Limb sensations vary, but they are almost always relieved by movement. Although abnormal limb sensations are part of the syndrome, abnormal movements also can occur. The abnormal sensation and movements can worsen at night and during sleep. Many patients with RLS cannot sleep through the night and RLS can be part of a sleep apnea disorder or insomnia.
"Quality of life is affected in a major way for people who have severe RLS, says Georgianna Bell, executive director of the RLS Foundation. "Many people suffer from extreme sleep deprivation, but that is not all. For some people, normal activities like going out to dinner or going to a theater are out of the question, because they can't sit for long periods."
Bell tells WebMD that misdiagnosis is common, and many people with RLS are prescribed antidepressants because symptoms can mimic those seen with depression. Dopamine-like drugs and other drugs used to treat Parkinson's disease are commonly used to treat RLS patients, but serious short-term and long-term side effects are common.
In the newl study, researchers in Spain used the epilepsy drug gabapentin to treat 24 patients with RLS. Half the patients were treated with gabapentin and the other half with placebo for six weeks. The groups were then switched and the placebo group received active treatment, while the treated group got the dummy pills for another six-week period.
Physical and neurological examinations, including detailed sleep studies, were conducted at the start of the investigation, and at the end of each course of treatment. Sleep studies showed that leg movements became less frequent in patients on gabapentin, and their sleep time and overall sleep quality also improved. The patients on active therapy also reported significant reductions in pain.
"The more severe the symptoms, the more robust the therapeutic effects of gabapentin, suggesting that gabapentin is a potent agent for treatment of even severe RLS," researcher Diego Garcia-Borreguero, MD, and colleagues wrote in the Nov. 26 issue of the journal Neurology. The study was funded by Pfizer, which makes gabapentin under the name Neurontin.
Daytime sedation, which is a common side effect of treatment with dopamine drugs, was not considered to be a problem by patients on the active therapy.
"Our study shows the therapeutic effects of gabapentin in RLS under controlled conditions," the researchers write. "However, additional long-term studies are needed to confirm the therapeutic effects and to examine the tolerance during chronic treatment."