Treatments For Movement Disorders - Movement Disorders In Sleep: Sleep Disorders
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Treatments for movement disorders
There is no single diagnostic test for RLS or PLMD, and standard neurological examinations often reveal no abnormality.
Dopaminergic drugs that ease the tremors of Parkinson's disease also reduce the number of leg movements and thus improve quality of life for people with RLS and PLMD. Levodopa-carbidopa (Sinemet), pergolide (Permax), and pramipexole (Mirapex) are first-line treatments for these disorders (see Table 3). While the drugs used to treat RLS and PLMD are the same as those used in treating Parkinson's disease, people with these sleep disorders are no more likely to develop Parkinson's disease than other individuals.
Table 3: Medications for movement disorders | |||
| Generic name | Brand name | Side effects | Comments |
| bromocriptine | Parlodel | Nausea, abnormal movements, hallucinations, confusion, dizziness, fainting, digestive problems | Should not be used if sensitive to ergot drugs or in cases of uncontrolled hypertension. |
| Clonazepam, diazepam | Klonopin, Valium | Clumsiness or unsteadiness, dizziness, lightheadedness, daytime drowsiness, headache | Should not be used by persons with sleep apnea or other breathing difficulties; not to be used with alcohol or other depressants; habit-forming; withdrawal symptoms occur if stopped abruptly. |
| levodopa-carbidopa | Sinemet | Abnormal movements, depression, mental changes, nausea, dizziness | Should not be used with monoamine oxidase inhibitors (MAOIs), or in cases of glaucoma. |
| oxycodone | Roxicodone, Oxycontin | Depressed breathing and circulation, dizziness or lightheadedness, next-day sedation, constipation, nausea, vomiting | Risk of addiction; not to be used by persons with sleep apnea; should not be used with alcohol or other depressants. |
| pergolide | Permax | Abnormal movements, hallucinations, nausea, constipation, diarrhea, runny nose, dizziness | Should not be used if sensitive to ergot drugs, often used for migraine headaches. |
| pramipexole | Mirapex | Nausea, abnormal movements, hallucinations, confusion, dizziness, fainting, digestive problems | Should not be used if sensitive to ergot drugs or in cases of uncontrolled hypertension. |
| propoxyphene | Darvon | Depressed breathing and circulation, dizziness or lightheadedness, next-day sedation, constipation, nausea, vomiting | Risk of addiction; not to be used by persons with sleep apnea; should not be used with alcohol or other depressants. |
| temazepam | Restoril | Clumsiness or unsteadiness, dizziness, lightheadedness, daytime drowsiness, headache | Should not be used by persons with sleep apnea or other breathing difficulties; not to be used with alcohol or other depressants; habit-forming; withdrawal symptoms occur if stopped abruptly. |
| Note: Although the FDA has not approved any of these drugs for use in treating restless legs syndrome, physicians have found that they often help people with sleep-related movement disorders and therefore prescribe them. | |||
People with mild movement disorders may be prescribed diazepam (Valium), clonazepam (Klonopin), or temazepam (Restoril), which may help them stay asleep during leg movements. Most people who take these medications for insomnia develop a tolerance to them after a few weeks, but this doesn't seem to happen when such drugs are taken for RLS.
Because of the potential for addiction, most physicians are reluctant to treat sleep disturbances with opiates (opium-derivative drugs) such as propoxyphene (Darvon) and oxycodone (OxyContin). However, these drugs often help people with severe RLS symptoms that resist other treatments. The opiates decrease the discomfort of RLS and, for some patients, dramatically reduce leg movements at night. When properly used, they may provide long-term benefit with little risk of addiction.
| Last updated: | January 23, 2007 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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