Dopamine Agonists in the Treatment of Restless Legs Syndrome: Too Much of a Good Thing?

Restless legs syndrome is a prevalent sensorimotor sleep disorder that worsens the quality of life. Dopamine agonists are widely used to relieve the symptoms of restless legs syndrome, even though these patients are in a “hyperdopaminergic” state. This treatment paradox inevitably leads to augmentation syndrome. Here, we review the pathophysiological basis of this deterioration in patients treated with dopamine agonists. Other treatment options are required with a focus on the neuromodulation of dopaminergic or non-dopaminergic pathways.