Tag: Restless Legs Syndrome

Gabapentin is Used to Treat Restless Legs Syndrome

Restless legs syndrome (RLS) is a disorder of the part of the nervous system that causes an urge to move the legs. Because it usually interferes with sleep, it also is considered a sleep disorder.

 

Causes of Restless Legs Syndrome

In most cases, doctors do not know the cause of restless legs syndrome; however, they suspect that genes play a role. Nearly half of people with RLS also have a family member with the condition.

Other factors associated with the development or worsening of restless legs syndrome include:

  • Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinson’s disease, kidney failure,diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from RLS symptoms.
  • Medications. Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergymedications containing sedating antihistamines, may worsen symptoms.
  • Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.

Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.

Treatment for Restless Legs Syndrome

Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS-associated condition also may provide relief of symptoms.

Other non-drug RLS treatments may include:

Leg massages
Hot baths or heating pads or ice packs applied to the legs
Good sleep habits
A vibrating pad called Relaxis
Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time.

Drugs used to treat RLS include:

  • Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain.
  • Mirapex, Neupro, and Requip are FDA-approved for treatment of moderate to severe RLS. Others, such as levodopa, may also be prescribed.
  • Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness.
  • Narcotic pain relievers may be used for severe pain.
  • Anticonvulsants, or antiseizure drugs, such as Tegretol, Lyrica, Gabapentin ( Neurontin ), and Horizant.

Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep.

Usual Adult Dose for Restless Legs Syndrome

Gabapentin enacarbil available under the trade name Horizant (R):
600 mg orally once daily with food at about 5 PM

There are several non-pharmacological approaches that may help alleviate the symptoms of restless legs syndrome (RLS), including:

  1. Regular exercise: Engaging in moderate exercise, such as walking or yoga, on a regular basis may help reduce symptoms of RLS.
  2. Hot or cold compresses: Applying a hot or cold compress to the legs may help alleviate discomfort and reduce the urge to move the legs.
  3. Massage: Gentle massage or self-massage of the legs may help relax muscles and improve circulation.
  4. Compression stockings: Wearing compression stockings or socks may help improve blood flow and reduce symptoms of RLS.
  5. Relaxation techniques: Practicing relaxation techniques, such as deep breathing, meditation, or progressive muscle relaxation, may help reduce stress and tension in the body, which can exacerbate symptoms of RLS.
  6. Maintaining a regular sleep schedule: Establishing a regular sleep schedule, including a consistent bedtime and wake-up time, may help improve sleep quality and reduce symptoms of RLS.
  7. Avoiding triggers: Avoiding triggers such as caffeine, alcohol, and nicotine, as well as certain medications, may help reduce symptoms of RLS.

It is important to note that these approaches may not work for everyone with RLS, and individuals should talk to their healthcare provider before starting any new treatment regimen.

There are several medications that may be prescribed to alleviate the symptoms of restless legs syndrome (RLS), including:

  1. Dopamine agonists: These medications increase the levels of dopamine, a neurotransmitter that helps regulate movement and sensation, in the brain. Examples include pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro).
  2. Iron supplements: Iron deficiency can contribute to RLS symptoms, so taking iron supplements may help alleviate symptoms in some individuals.
  3. Anticonvulsants: Certain anticonvulsant medications, such as gabapentin (Neurontin) and pregabalin (Lyrica), may help alleviate symptoms of RLS by modulating the levels of certain neurotransmitters in the brain.
  4. Opioids: In some cases, opioids such as oxycodone or hydrocodone may be prescribed to alleviate severe symptoms of RLS, although their use is generally reserved for individuals with severe symptoms who have not responded to other treatments.

It is important to note that all medications carry some risks, and individuals should talk to their healthcare provider about the potential benefits and risks of any medication before starting treatment. In addition, treatment for RLS may need to be adjusted over time, as the effectiveness of certain medications may diminish or side effects may become problematic.

Gabapentin is Used for Restless legs syndrome

Gabapentin in the management of restless legs syndrome (RLS) has been evaluated in small controlled trials, demonstrating benefits compared with placebo.

Gabapentin is sometimes used off-label for the treatment of restless legs syndrome (RLS), which is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by unpleasant sensations such as tingling or crawling.

While the exact mechanism of action of gabapentin in RLS is not well understood, it is believed that gabapentin may help alleviate RLS symptoms by modulating the levels of certain neurotransmitters in the brain, including gamma-aminobutyric acid (GABA) and glutamate.

However, it is important to note that the effectiveness of gabapentin for the treatment of RLS is still under investigation, and more research is needed to determine the optimal dosage, treatment duration, and potential side effects. Patients with RLS should always consult their healthcare provider before starting or changing any medication regimen.

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move the legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you’re sitting or lying down. Moving eases the unpleasant feeling temporarily.

Restless legs syndrome, also known as Willis-Ekbom disease, can begin at any age and generally worsens as you age. It can disrupt sleep, which interferes with daily activities.

Simple self-care steps and lifestyle changes may help relieve symptoms. Medications also help many people with RLS.

Gabapentin enacarbil is FDA-approved for the treatment of RLS .

The American Academy of Sleep Medicine (AASM) guidelines regarding RLS management consider gabapentin effective based on low-level evidence and note that patients with pain symptoms appeared to benefit most.

The benefit-risk ratio is unclear. The European Federation of Neurological Societies/European Neurological Society/European Sleep Research Society (EFNS/ENS/ESRS) Task Force guidelines consider gabapentin effective for short-term management and possibly effective for long-term management of RLS.

Additional study is needed to establish optimal dosing. Based on the International Restless Legs Syndrome Study Group, European Restless Legs Syndrome Study Group, and RLS Foundation (IRLSSG/EURLSSG/RLS-F) guidelines for the prevention and treatment of dopaminergic augmentation in restless legs syndrome, α2δ ligands (eg, gabapentin) are effective and should be considered for the initial treatment of patients with RLS due to their minimal risk of augmentation.

Additionally, patients who experience augmentation on dopaminergic agents may benefit from a switch to α2δ ligands (eg, gabapentin). However, the guidelines note that long-term studies are needed.

There are several non-pharmacological approaches that may help alleviate the symptoms of restless legs syndrome (RLS), including:

  1. Regular exercise: Engaging in moderate exercise, such as walking or yoga, on a regular basis may help reduce symptoms of RLS.
  2. Hot or cold compresses: Applying a hot or cold compress to the legs may help alleviate discomfort and reduce the urge to move the legs.
  3. Massage: Gentle massage or self-massage of the legs may help relax muscles and improve circulation.
  4. Compression stockings: Wearing compression stockings or socks may help improve blood flow and reduce symptoms of RLS.
  5. Relaxation techniques: Practicing relaxation techniques, such as deep breathing, meditation, or progressive muscle relaxation, may help reduce stress and tension in the body, which can exacerbate symptoms of RLS.
  6. Maintaining a regular sleep schedule: Establishing a regular sleep schedule, including a consistent bedtime and wake-up time, may help improve sleep quality and reduce symptoms of RLS.
  7. Avoiding triggers: Avoiding triggers such as caffeine, alcohol, and nicotine, as well as certain medications, may help reduce symptoms of RLS.

It is important to note that these approaches may not work for everyone with RLS, and individuals should talk to their healthcare provider before starting any new treatment regimen.

 

How Long Does it take Gabapentin to Work?

It can take several weeks for gabapentin to reach its full effect, but this depends on the condition being treated.

Gabapentin is approved to treat:

      • Nerve pain
      • Some types of seizures
      • Restless legs syndrome (RLS)

It also depends on your individual response to the drug. The time gabapentin takes to work is not the same for everyone.

The effective dose of gabapentin is also very different for each person. It may vary from 300 mg per day to up to 3,000 mg per day.

Another reason gabapentin takes time to work is that the dose is usually started low and gradually increased over time to reach an effective dose.

For example, when used to relieve nerve pain, the initial dose may be started at 300 mg and increased by 300 mg daily over several days, gradually reaching up to 600 mg three times per day. Studies for nerve pain treatment show that pain relief may begin within 1 week, with the maximum effect reached after about 4 weeks.

Gabapentin is in a class of medications called anticonvulsants. It is not completely known how this drug works. When used to treat a type of seizure disorder, called a partial onset seizure, gabapentin decreases the abnormal activity in the brain that causes the seizures. When used to treat nerve pain, or neuralgia, following a herpes zoster (shingles) infection, gabapentin may reduce the response to painful stimuli. It is unknown how gabapentin relieves symptoms of restless legs syndrome.

Even though it may take up to 4 weeks to get the full effects of gabapentin, it is important not to stop taking it suddenly. That could cause withdrawal symptoms such as:

      • Anxiety
      • Insomnia
      • Nausea
      • Pain

If you are taking gabapentin to control seizures, stopping suddenly may increase your risk of a seizure.

Common side effects of Gabapentin

These common side effects of gabapentin may happen in more than 1 in 100 people. They’re usually mild and go away by themselves.

There are things you can do to help cope with them:

    • Feeling sleepy, tired or dizzy
    • Feeling sick (nausea)
    • Being sick (vomiting)
    • Diarrhoea
    • Mood changes
    • Swollen arms and legs
    • Blurred vision
    • Dry mouth
    • Difficulty getting an erection
    • Weight gain
    • Memory problems
    • Headaches
    • Getting more infections than usual

Keep taking the medicine, but talk to your doctor if this advice does not help and the side effects bother you or do not go away.

 

Is Gabapentin Considered a Painkiller?

Gabapentin is commonly used to treat some types of nerve pain but is classified as an anticonvulsant medicine, not as an opioid or painkiller.

Gabapentin was first approved in 1993 and is used to treat:

    • postherpetic neuralgia, a nerve pain caused by the shingles virus (herpes zoster),
    • restless legs syndrome (RLS), a painful movement disorder in the legs
    • partial seizures in adults and children at least 3 years old who have epilepsy

Gabapentin works by affecting chemicals and nerves in the body that are involved in the cause of seizures and in some types of nerve pain.

Gabapentin is not a federally-controlled drug substance and does not contain an opioid (narcotic) medication. However, gabapentin misuse and abuse has been reported, and it may be restricted in some states through their state drug-monitoring program. Gabapentin abuse can boost the high a person gets from opioid painkillers, muscle relaxants, and anxiety medications. This can be dangerous and potentially life-threatening.

In 2019, the FDA issued an alert that serious breathing problems have been reported with gabapentin and other related drugs, like Lyrica (pregabalin) in people at risk of slowed breathing.

    • This includes people who use opioid pain medicine or CNS depressants, people with chronic obstructive pulmonary disease (COPD, and the elderly.
    • These serious breathing problems may be fatal.
    • Read more about this serious FDA warning here.

Avoid or limit the use of alcohol (in beverages or medicines) with gabapentin as it can worsen drowsiness or dizziness. Ask you doctor about drinking alcohol while you are taking gabapentin.

What type of pain does gabapentin treat?

Gabapentin is approved by the FDA to treat:

Postherpetic neuralgia: nerve pain that can occur due to an outbreak of shingles. Shingles, also known as herpes zoster, occurs when the chicken pox virus deep-seated in your nerve activates again later in life and causes a serious skin rash. Not everyone gets postherpetic neuralgia from shingles, but it can be painful if you do. It causes a burning nerve pain that lasts for months, or even years, after the rash and blisters have cleared up.

Restless legs syndrome (RLS): an uncontrollable urge to move your legs around, often at night. This is usually due to leg discomfort. It may occur most often when you are sitting, laying down, or during bedtime. It can be disruptful to sleep and travel. It is thought RLS may occur due to an imbalance of the chemical dopamine in the brain.

Gabapentin has also been used off-label for the treatment of other types of neuropathic (nerve) pain like peripheral diabetic neuropathy, fibromyalgia and trigeminal neuralgia. “Off-label” uses of gabapentin are uses that have not been approved by the FDA and are not found in the package insert, but may have been accepted for use by healthcare providers based on clinical use.

How does gabapentin come?

There are several brand names of gabapentin including Gralise, Horizant, and Neurontin. Use only the brand and form of gabapentin your doctor has prescribed.

Gralise (gabapentin) is indicated for the management of postherpetic neuralgia only. It is not used for epilepsy. Gralise comes as a 300 and 600 milligram (mg) extended-release (ER) tablet and in a 30-day starter pack of 78 tablets. A generic option is not yet available.

Horizant (gabapentin enacarbil) is used in adults to treat either nerve pain due to postherpetic neuralgia (PHN) or restless legs syndrome (RLS). Horizont is also an extended-release 300 mg or 600 mg tablet and is not interchangeable with other gabapentin products. A generic option is not yet available.

Neurontin (gabapentin) is an immediate-release form used to treat seizures in adults and children who are at least 3 years old, in addition to nerve pain due to shingles. It comes as 100, 300, or 400 mg oral capsules; 600 mg and 800 mg oral tablets, and as a 250 mg per 5 mL oral solution. It is also available as a generic option.

Some brands are only used for certain conditions, and these products may not be interchangeable. Check your medicine each time you get a refill to make sure you have received the correct form.

Some of these medicines may be expensive. Ask your healthcare provider if you are able to use a generic form of gabapentin for your condition (this may not always be possible). Generic options could save you hundreds of dollars each month, or may be less expensive than your insurance copay.

Also, check with the manufacturer who may offer copay cards or patient assistance programs to lessen your overall costs, if you qualify. Be sure to check for online coupons, too, that can save you money on both generics and brands.

To learn more about gabapentin, join the Drugs.com gabapentin Support Group and Q&A Section where you can ask questions, share experiences and keep up with the latest news.

This is not all the information you need to know about gabapentin for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full gabapentin information here, and discuss this information and any questions you have with your doctor or other health care provider.

Gabapentin is used for Restless legs syndrome

Gabapentin in the management of restless legs syndrome (RLS) has been evaluated in small controlled trials, demonstrating benefits compared with placebo.

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move the legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you’re sitting or lying down. Moving eases the unpleasant feeling temporarily.

Restless legs syndrome, also known as Willis-Ekbom disease, can begin at any age and generally worsens as you age. It can disrupt sleep, which interferes with daily activities.

Simple self-care steps and lifestyle changes may help relieve symptoms. Medications also help many people with RLS.

Gabapentin enacarbil is FDA-approved for the treatment of RLS .

The American Academy of Sleep Medicine (AASM) guidelines regarding RLS management consider gabapentin effective based on low-level evidence and note that patients with pain symptoms appeared to benefit most.

The benefit-risk ratio is unclear. The European Federation of Neurological Societies/European Neurological Society/European Sleep Research Society (EFNS/ENS/ESRS) Task Force guidelines consider gabapentin effective for short-term management and possibly effective for long-term management of RLS.

Additional study is needed to establish optimal dosing. Based on the International Restless Legs Syndrome Study Group, European Restless Legs Syndrome Study Group, and RLS Foundation (IRLSSG/EURLSSG/RLS-F) guidelines for the prevention and treatment of dopaminergic augmentation in restless legs syndrome, α2δ ligands (eg, gabapentin) are effective and should be considered for the initial treatment of patients with RLS due to their minimal risk of augmentation.

Additionally, patients who experience augmentation on dopaminergic agents may benefit from a switch to α2δ ligands (eg, gabapentin). However, the guidelines note that long-term studies are needed.