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ISSUE 6 DECEMBER
Letters to the Editor

Restless legs syndrome

  • Douglas Johnson, Professor Thyagarajan

The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

 

Letter to the Editor

Editor, – Restless legs syndrome occasionally occurs in pregnancy, but no mention was made of how this condition should be treated in Professor Thyagarajan's article on the topic (Aust Prescr 2008;31:90-3).

Benzodiazepines and antiepileptic medication have been advocated in the past. Usually the symptoms are not severe and women can cope until pregnancy is over. Are there any studies concerning the effectiveness and safety of low-dose dopamine agonists in pregnancy?

Douglas Johnson
General practitioner
Mornington, Vic.

 

Author's comments

Professor Thyagarajan, author of the article, comments:

There are very few studies of pharmacotherapy for restless legs syndrome in pregnancy and none of these involve dopaminergic drugs. However, Dr Johnson points out that it is a common problem in pregnancy, usually mild and resolves with the completion of pregnancy. Iron status should first be determined by measurement of the serum ferritin.

The teratogenicity of dopamine agonists is unknown and they cannot be recommended at present; nor is it likely that future trials will address this safety and efficacy question. If pharmacotherapy is needed, opioids, anticonvulsants such as gabapentin or carbamazepine, or benzodiazepines, all have a better safety track record during pregnancy and should be tried first.

 

References

  1. Garcia-Bournissen F. Medications for restless legs syndrome in pregnancy. J Obstet Gynaecol Can 2008;30:505-7 .

Douglas Johnson

General practitioner, Mornington, Vic

Professor Thyagarajan