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Iron supplementation for restless legs syndrome.

Thirty patients (aged 20-80 years; mean age, 56 years) with restless legs syndrome and a low-normal serum ferritin level (15-50 ng/ml; suggestive of low or borderline-low iron status) were randomly assigned to receive ferrous sulfate (325 mg twice a day) or pramipexole (0.25 mg at bedtime, with the dosage adjusted at 2, 4, and 8 weeks according to response and tolerance) for 12 weeks. Symptom severity was assessed using the International Restless Legs Syndrome Study Group Rating Scale (IRLS) for severity. Treatment response was defined as a decrease in IRLS score of at least 50% from baseline. At baseline, IRLS scores and serum ferritin levels were similar between groups. Both groups improved significantly; the mean improvement was 41.6% with iron and 39.7% with pramipexole (difference between groups not significant). The response rate was 46.7% in each group.

Comment: Previous research has demonstrated that iron deficiency is a common cause of restless legs syndrome. Iron supplementation has been shown to be beneficial both in patients with overt iron deficiency and in those with low-normal iron status. Pramipexole is a dopamine agonist that has been approved by the FDA for the treatment of restless legs syndrome. It can cause a wide range of side effects, including headache, edema, sedation, and abnormal movements. The results of the present study demonstrate that iron supplementation is as effective as pramiprexole in patients with restless legs syndrome and a low-normal serum ferritin level.

Lee CS et al. Comparison of the efficacies of oral iron and pramipexole for the treatment of restless legs syndrome patients with low serum ferritin. Eur J Neurol. 2014;21:260-266.

by Alan R. Gaby, MD

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Title Annotation:Literature Review & Commentary
Author:Gaby, Alan R.
Publication:Townsend Letter
Article Type:Brief article
Date:Aug 1, 2015
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