Handling the problem of augmentation in restless legs syndrome (RLS)

Sensorimotor symptoms of RLS typically appear at rest and are present predo minantly at night-time. Perodic leg movements (PLM) during sleep and relaxe d wakefulness contribute to considerably disturbed sleep. Symptoms during t he day may either develop over the years when the disease progresses or may appear under pharmacological therapy, which is referred to as augmentation . Augmentation has been observed under levodopa therapy and less often unde r pergolide. An open pilot trial with an observation period of 3 months in nine patients showed for the first time that cabergoline improves nocturnal RLS symptoms and relieves daytime symptoms in patients who developed augme ntation under levodopa, Cabergoline at a mean dosage of 2.1 mg (rauge 1-4 m g) significantly reduced the number of PLM (195.8 vs. 26.4: P = 0.002) and PLM arousal (51.7 vs. 6.4; P = 0.017) compared to baseline. Total sleep tim e was prolonged (302.7 vs. 379.4 min; P = 0.018), sleep latency was shorten ed (42.4 vs. 16.3 min; P = 0.214), and sleep efficiency increased (63.1% vs . 79.1%; P = 0.017).