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Restless legs syndrome: can be caused by medication

Some drugs can cause or exacerbate restless legs syndrome. Reducing the dosage or halting the suspected drug often results in an improvement for the patient.

Some forms of restless legs syndrome can be caused by medication. This syndrome covers a broad spectrum of unpleasant symptoms: a burning sensation, a crawling feeling, numbness in the lower limbs and sometimes in the torso and arms.

The symptoms appear when the patient is resting, either sitting or lying down, and are more intense in the evening or at night. Temporarily relieved by moving the limb, they can sometimes be very uncomfortable, but do not lead to any severe physical complications.
In most cases, there is no identifiable cause. Sometimes this syndrome is triggered or exacerbated by medication, most often psychotropic drugs (especially antidepressants and neuroleptic drugs).

Some drugs are used to relieve restless legs syndrome. However, after affording modest relief initially, they are likely to aggravate the symptoms.
When a drug is the cause, the restless legs syndrome occurs  within a few days or weeks after the beginning of the drug treatment. In some cases, there is a correlation between the intensity of the symptoms and the dosage, but cases occur even in patients on low doses.

The symptoms clear up rapidly after a reduction in the dosage or halting the drug. After the dosage is increased and/or the same drug is reintroduced, the symptoms generally reappear.

©Prescrire August 2010

"Drug-induced restless legs syndrome" Prescrire Int 2010; 19 (108): 164-165 (pdf, subscribers only).
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