Restless Legs Syndrome

Restless Leg Syndrome (RLS) is also called Willis-Ekbom Disease. It is the most common movement disorder, characterized by an irresistible, often uncomfortable, urge to move the legs when at rest.

RLS affects up to 10% of people in the U.S. Anyone can get it, but it is more common in women, and middle-aged people are more likely to have severe symptoms.

Symptoms of Restless Leg Syndrome

At least 80 percent of people with RLS have a related condition called Periodic Limb Movement of Sleep (PLMS). PLMS causes the legs to twitch or jerk during sleep.

The pattern of movements with RLS is intermittent throughout the night. You may or may not notice your symptoms, but bed partners tend to notice the excessive movements.

Treatments for Restless Leg Syndrome

Lifestyle modification is the first step of treating people with mild or infrequent symptoms.

Lifestyle changes can include:

• Decreasing alcohol and tobacco use

• Changing or maintaining a regular sleep schedule

• Adding moderate exercise, like yoga, to your routine

• Massaging the legs

• Taking warm baths

If you have moderate to severe RLS, your doctor will likely suggest one or more medications. Dopaminergic drugs are typically a primary RLS treatment. These FDA approved medications may include

• Ropinirole (Requip)

• Rotigotine (Neupro)

• Pramipexole (Mirapex)

Does Quinine Help Restless Legs Syndrome?

Quinine has been used to treat muscle cramps since the 1930s. It was approved by the FDA for the treatment of malaria in August 2005.

Approximately 92% of Quinine use is associated with the off-label indication relating to the treatment of leg cramps and muscle pain.

On December 12, 2006, the FDA removed all the unapproved Quinine medications (except the branded product – Qualaquin) from the market and cautioned consumers about the off-label use of Quinine to treat leg cramps, because of the risk of serious side effects or death.

Despite the warnings, Quinine is still prescribed to individuals with muscle cramps of unknown origins. Some doctors do suggest a carefully monitored four- to six-week trial of quinine for patients whose leg cramps are not relieved by other means.

If your doctor prescribes it for your RLS, and you decide to try Quinine, make sure that you are not at increased risk for serious side effects because of your health or other medications you may be taking (see caution below). Also, be aware that the appropriate dosage for leg cramps is unknown, though it is typically much lower than the recommended dosage for the treatment of malaria.

Caution About Medications

Sometimes dopamine medications that have worked for a while to relieve your RLS become ineffective, or you notice your symptoms returning earlier in the day or involving your arms. This is called augmentation. Your doctor may substitute another medication to combat the problem.

Most medications prescribed to treat RLS are not recommended during pregnancy.

As for Quinine, some of the more serious side effects that can result in hospitalization, serious illness, and death include thrombocytopenia, cardiac problems, rashes and other allergic reactions, thrombotic thrombocytopenic purpura—a rare, often fatal blood condition that causes clotting throughout the body, hearing problems, eye problems, electrolyte imbalance (the amount of minerals and fluids in the body), kidney failure and lung toxicity.