Treatment of Restless Legs Syndrome

To the Editor. —We read with interest Akpinar's recent report (Archives1982;39:739) on the beneficial effect of a levodopa-benserazide combination in relieving restless legs syndrome. That this drug regimen has not produced insomnia in their patients is noteworthy. Large doses of levodopa are known to increase waking time 1 and to decrease rapid eye movement sleep 2 in normal subjects. Because restless legs syndrome appears only at rest, and mostly before bedtime, a treatment that facilitates sleep may be more appropriate for this condition. It has been reported that certain benzodiazepines, especially clonazepam, relieve restless legs syndrome dramatically. 3,4 In our animal model for myoclonus, in which the myclonic jerks are localized in the hind quarter (and hence resemble restless legs syndrome more closely than does myoclonus), clonazepam and flunitrazepam were 33 and 116 times more effective than diazepam, respectively, in blocking these jerks. 5 This finding warrants the clinical