- Natural solutions -- mild cases of RLS often respond well to natural strategies such as regular exercise and the avoidance of caffeine, alcohol and tobacco. Some people find it helpful to massage their legs or use a heating pad or ice pack at bedtime, while others distract themselves from their discomfort by reading or listening to music. Do all you can to promote high-quality sleep, including keeping regular hours, following a bedtime routine, taking warm baths -- whatever works best for you.
- Discuss with your doctor all medications you take on a regular basis. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), or certain tricyclic antidepressants such as imipramine (Tofranil) may worsen the problem. Other drugs including certain antinausea drugs, some cold and allergy medications, and some antipsychotic and antiseizure drugs can similarly aggravate symptoms. Talk with your doctor before stopping or switching drugs and ask about alternative medications if the drugs are indeed exacerbating your RLS symptoms.
- Have your iron levels tested. Since RLS has been associated with low iron levels, your health care provider may prescribe an iron supplement or make dietary recommendations to help correct low levels.
- Possible drug treatments include dopaminergic drugs such as levodopa (largely used to treat Parkinson's disease)... opiates (narcotic painkillers) such as oxycodone... benzodiazepines (tranquilizers) such as clonazepam... and anticonvulsant agents such as carbamazepine and gabapentin. Dr. Downey cautions that these drugs all have potentially serious side effects, and "physicians must be certain that the treatment given meets the degree of symptoms and impairment the patient experiences."
Ralph Downey III, PhD, D.ABSM, chief, sleep medicine, Loma Linda University Medical Center, associate professor of medicine, pediatrics, and neurology, Loma Linda University School of Medicine, Loma Linda, California, and adjunct associate professor of psychology, University of California, Riverside, California