A patient diagnosed with Restless Legs Syndrome complains that her symptoms are affecting her quality of life despite taking pramipexole. What additional treatment options are available?
If a patient with Restless Legs Syndrome (RLS) is not responding adequately to pramipexole, other treatment options can be considered. Alternatives include other dopaminergic agents (such as ropinirole or rotigotine), gabapentin or pregabalin, or even low-dose opioids for refractory cases. In some cases, combination therapy may be considered. Non-pharmacologic interventions should also be reinforced, such as regular exercise, good sleep hygiene, and avoidance of caffeine or other potential triggers.