Reme­dies vs. drugs for rest­less leg trou­bles

The Buffalo News - - LIFE COLUMNS - By Joe and Teresa Grae­don

It’s al­most im­pos­si­ble to de­scribe rest­less leg syn­drome. Peo­ple who have never ex­pe­ri­enced the creep­y­crawly sen­sa­tion that qui­ets only upon mov­ing the legs have a hard time imag­in­ing what vic­tims go through.

One per­son ex­plained: “The best way I can de­scribe it is un­bear­able sen­sa­tions that start as un­com­fort­able and then keep in­creas­ing and in­creas­ing in your legs (not pain but a ter­ri­ble feel­ing).

All you want to do is get rid of the feel­ing by walk­ing, mov­ing your legs on the bed, punch­ing or rub­bing your legs, oft­times to no avail.”

The cause of RLS is mys­te­ri­ous. How­ever, doc­tors have four med­i­ca­tions that they can pre­scribe to help peo­ple with RLS. These drugs all af­fect brain chem­istry.

Three tar­get the neu­ro­trans­mit­ter dopamine and also are used to treat Parkin­son’s dis­ease. They in­clude ropini­role (Re­quip), pramipex­ole (Mi­rapex) and the trans­der­mal patch rotig­o­tine (Ne­upro). Like most med­i­ca­tions, these can cause side ef­fects, such as dry mouth or drowsi­ness. Some peo­ple fall asleep in the mid­dle of the day with no ad­vance warn­ing. Need­less to say, this can make driv­ing dan­ger­ous.

In ad­di­tion, these drugs can cause some un­ex­pected re­ac­tions. Most peo­ple are taken aback when they dis­cover that they have an uncontrollable urge to gam­ble, shop com­pul­sively or binge eat. One woman wrote us: “I thought I’d fi­nally found the best med­i­ca­tion for my RLS. Then I started to gam­ble. It is out of con­trol to the ex­tent that my hus­band and I have sep­a­rated. I also lost my good-pay­ing job and am in fi­nan­cial trou­ble.

“I can’t stop gam­bling, though I never gam­bled be­fore in my life. I want to stop tak­ing my pramipex­ole, but then what will I do about my RLS? If I don’t take my meds, I can’t sleep and I’m in pain with all the leg jump­ing.”

The fourth med­i­ca­tion is re­lated to a com­mon an­ti­con­vul­sant, gabapentin. Gabapentin enacar­bil (Horizant) is ap­proved for treat­ing pain af­ter shin­gles (pos­ther­petic neu­ral­gia) as well as for RLS. When the Food and Drug Ad­min­is­tra­tion ap­proved this med­i­ca­tion, it re­quired a warn­ing that the drug “may cause sig­nif­i­cant driv­ing im­pair­ment.” This may be due in part to sleepi­ness and dizzi­ness. Other side ef­fects in­clude headache, nau­sea and fa­tigue.

It’s no won­der that many RLS pa­tients look for al­ter­na­tive ap­proaches, like rub­bing legs with laven­der oil. Some peo­ple find it help­ful to put a bar of soap un­der the bot­tom sheet near the legs. One gen­tle­man told us that since he started us­ing a pop­u­lar brand of soap, he has been able to re­duce his dose of Mi­rapex and get good sleep.

A vis­i­tor to our web­site re­ported: “Thanks to Peo­ple’s Phar­macy, I’ve used soap (sliv­ers of any brand, sam­ple­size bars of any kind) un­der the bot­tom sheet, sprin­kled where my legs will be. It’s mirac­u­lous!”

Such home reme­dies won’t work for ev­ery­one, but they are less likely to cause un­pleas­ant side ef­fects.

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