A patient diagnosed with Restless Legs Syndrome (RLS) is experiencing augmentation, a worsening of symptoms after initial improvement with dopaminergic treatment. What are the potential management strategies for this patient?
Augmentation is a known complication of dopaminergic treatment in Restless Legs Syndrome (RLS). If a patient experiences augmentation, the first step could be to reduce the dose of the dopaminergic drug, although this might lead to initial worsening of symptoms. Alternatively, changing the timing of the medication to later in the day or changing to a long-acting formulation could also be considered. If these strategies are unsuccessful, the dopaminergic drug could be slowly withdrawn and replaced with a non-dopaminergic medication, such as gabapentin, pregabalin, or a low-dose opioid.