L-DOPA THERAPY OF UREMIC AND IDIOPATHIC RESTLESS LEGS SYNDROME - A DOUBLE-BLIND, CROSSOVER TRIAL

We report the effects of a single bedtime dose of L-dopa 100-200 mg on sleep quality, frequency of periodic leg movements (PLM) and daily li ving in patients with idiopathic and uremic restless legs syndrome (RL S). Seventeen patients with idiopathic and 11 with uremic (on continuo us hemodialysis) RLS were evaluated comparatively by polysomnography, actigraphy and subjective ratings in a randomized, controlled and doub le-blind crossover trial with L-dopa and placebo for 4 weeks each. Neu rophysiologic assessments showed significant reduction of the number o f periodic leg movements (p = 0.003) and the PLM-index (p = 0.005) mos t pronounced during the first 4 hours of bedtime after L-dopa (p = 0.0 01). Subjective evaluation confirmed improvement of sleep quality (p = 0.002) and showed significantly higher quality of life during daytime (p = 0.030) while the patients received L-dopa therapy. We conclude t hat L-dopa 100-200 mg proved to be effective in idiopathic RLS and for the first time under controlled conditions in uremic RLS without any severe side effects.