Pregabalin improves restless leg syndrome with less symptom augmentation

This carefully conducted study is one of a few head-to-head studies of two classes of medications that have been reported for the treatment of restless leg syndrome. It presents compelling evidence for the efficacy of a nondopaminergic drug in the treatment of RLS and thereby implicates a role for nondopaminergic pathways in the disease, said Dr. Sudhansu Chokroverty.

Although augmentation occurred significantly more often with pramipexole, patients who took pregabalin still had a rate of 1.7%, which "raises the question of whether augmentation is related to medication, is intrinsic to RLS, or is related to individual patient characteristics," he noted.

Dr. Chokroverty is with the department of neurology at the New Jersey Neuroscience Institute, JFK Medical Center, Edison N.J., and at Seton Hall University in South Orange. He reported no relevant financial conflicts of interest. These remarks were taken from his editorial accompanying Dr. Allen’s report (N. Engl. J. Med. 2014 Feb. 12 [doi:10.1056/NEJMe1313155]).