Pregabalin in restless legs syndrome with and without neuropathic pain

BACKGROUND: Restless legs syndrome (RLS) is a common neurological disorder complicated in many patients by augmentation to dopaminergic therapy or comorbidities such as neuropathic pain. AIMS: To explore the effectiveness of pregabalin in RLS in a pragmatic clinical setting. METHODS: After observing improvement of restless legs symptoms in seven patients treated with pregabalin for neuropathic pain, we extended the clinical observation to a total of 16 patients with secondary RLS, in most of them due to neuropathy, and to three patients with idiopathic RLS. RESULTS: Three patients discontinued pregabalin because of side effects (rash, fatigue, loss of efficacy). The other 16 patients self-rated a satisfactory or good alleviation of RLS symptoms and maintained pregabalin, five with add-on medication, on a mean daily dose of 305 mg (standard deviation, 185 mg), and with a mean duration of 217 (standard deviation, 183) days. CONCLUSION: These data propose pregabalin as a new option in the treatment of secondary RLS for patients with neuropathic pain, which should be further investigated with randomized, placebo-controlled trials.