HOUSTON – Restless legs can be uncomfortable and uncontrollable. The kicking, moving and heebie-jeebies feeling can make it hard to sleep or sit still at all and frustrates patients who feel like there is no relief.
Dr. William Ondo at Houston Methodist Hospital said current medications on the market for Restless Leg Syndrome (RLS) are effective, but there has not been anything new in decades, and for people who have been taking them for that long, they can stop working.
“These days I end up spending more time dealing with augmentation for people that had been successfully treated on these medicines much more than I see patients that have never been on them at all,” Ondo said.
He said all of the medications used to treat RLS have side effects.
“(They are) basically opioid medicines," Ondo said. “We’re never thrilled about using these chronically, but Methadone, in particular, can be a very effective medicine. We’ve had patients on them for 15, 20 years, we’ve never had to increase the dose. We like methadone because it doesn’t have as much addiction issues as other opioids.”
During the day, Ondo said movement and intense concentration can temporarily stop the discomfort.
“A video game sometimes can improve RLS," Ondo said. “Being angry can improve RLS. Getting into an argument can improve RLS. Sex can improve RLS. Unfortunately, things just like reading or watching TV, even if it’s a fairly intense show, generally don’t help RLS. It has to be a more active thought process than that.”.
Who gets restless legs?
Ondo said it partially has to do with genetics and women are usually more at risk, but other factors can play a role.
- Iron deficiency
- Kidney failure
- Pregnancy
It typically gets worse over the years until old age and surprisingly can get better among the elderly.
“Interestingly enough, as a rule of thumb it tends to worsen over the decades until you get to be very old, like 80 or 90-year-olds and then it tends to improve after that," Ondo said. “We’re not sure why that is, but then again it may have to do with the fact that when you get very old in your 80s and 90s your brain iron starts to go way up. That’s often thought to be a bad thing but in RLS it may be a good thing."