Opioids for restless legs syndrome

• Autor(a) principal: de Oliveira, Cesar Osorio [UNIFESP]
• Data de Publicação: 2016
• Outros Autores: Carvalho, Luciane Bizari Coin [UNIFESP], Carlos, Karla, Conti, Cristiane Fiquene, de Oliveira, Marcio Moysés, Prado, Lucila Bizari Fernandes., Prado, Gilmar Fernandes [UNIFESP]
• Tipo de documento: Artigo (review)
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1002/14651858.CD006941.pub2; http://repositorio.unifesp.br/handle/11600/49420
• topic: Limb Movement-Disorder; Ekbom Disease; Double-Blind; Sleep; Prevalence; Iron; Epidemiology; Validation; Dopamine; Placebo

Background Restless legs syndrome (RLS) is a distressing and common neurological disorder that may have a huge impact in the quality of life of those with frequent and intense symptoms. Patients complain of unpleasant sensations in the legs, at or before bedtime, and feel an urge to move the legs, which improves with movement, such as walking. Symptoms start with the patient at rest (e.g. sitting or lying down), and follow a circadian pattern, increasing during the evening or at night. Many pharmacological intervention are available for RLS, including drugs used to treat Parkinson's disease (L-Dopa and dopaminergic agonists), epilepsy (anticonvulsants), anxiety (benzodiazepines), and pain (opioids). Dopaminergic drugs are those most frequently used for treatment of RLS, but some patients do not respond effectively and require other medication. Opioids, a class of medications used to treat severe pain, seem to be effective in treating RLS symptoms, and are recommended for patients with severe symptoms, because RLS and pain appear to share the same mechanismin the central nervous system. All available drugs are associated to some degree with side effects, which can impede treatment. Opioids are associated with adverse events such as constipation, tolerance, and dependence. This justifies the conduct of a systematic review to ascertain whether opioids are safe and effective for treatment of RLS. Objectives To asses the effects of opioids compared to placebo treatment for restless legs syndrome in adults. Search methods We searched the Cochrane Central Register of Controlled trials, CENTRAL 2016, issue 4 and MEDLINE, EMBASE, and LILACS up to April 2016, using a search strategy adapted by Cochraneto identify randomised clinical trials. We checked the references of each study and established personal communication with other authors to identify any additional studies. We considered publications in all languages. Selection criteria Randomised controlled clinical trials of opioid treatment in adults with idiopathic RLS. Data collection and analysis Two review authors independently screened articles, independently extracted data into a standard form, and assessed for risk of bias. If necessary, they discussed discrepancies with a third researcher to resolve any doubts. Main results We included one randomised clinical trial (N = 304 randomised