The treatment of restless legs syndrome and periodic limb movement disorder

A task force consisting of six authors reviewed the published literature on the therapy of the restless legs syndrome or periodic limb movements in sl eep available in indices through April, 1998. They selected the 45 articles for detailed review which presented original investigations of therapeutic impact on the restless legs syndrome (RLS) or periodic limb movements (PLM ) and which met minimal standards. These articles dealt with a range of pha rmacological and other treatment modalities, although most dealt with medic ations and almost half of those concentrated on dopaminergic agents, especi ally levodopa in various formulations. Almost half of the articles reviewed used controlled methodologies, most commonly cross-over methodologies with randomized allocation of subjects. Multi-center studies with large numbers of subjects and long-term controlled studies were not found. Information w as extracted from the articles and study design, clinical definition, evalu ative measures, side effects, and outcomes were tabulated in 6 evidence tab les and summarized in the accompanying text. This literature was evaluated for the nature of the studies performed and its coverage of potential thera pies. The review concludes with comments on possible future directions for therapeutic investigation based on the current state of the literature.