Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
Sleep. 2012 Aug 1;35(8):1039-62. doi: 10.5665/sleep.1988.
A systematic literature review and meta-analyses (where appropriate) were performed to update the previous AASM practice parameters on the treatments, both dopaminergic and other, of RLS and PLMD. A considerable amount of literature has been published since these previous reviews were performed, necessitating an update of the corresponding practice parameters. Therapies with a STANDARD level of recommendation include pramipexole and ropinirole. Therapies with a GUIDELINE level of recommendation include levodopa with dopa decarboxylase inhibitor, opioids, gabapentin enacarbil, and cabergoline (which has additional caveats for use). Therapies with an OPTION level of recommendation include carbamazepine, gabapentin, pregabalin, clonidine, and for patients with low ferritin levels, iron supplementation. The committee recommends a STANDARD AGAINST the use of pergolide because of the risks of heart valve damage. Therapies for RLS secondary to ESRD, neuropathy, and superficial venous insufficiency are discussed. Lastly, therapies for PLMD are reviewed. However, it should be mentioned that because PLMD therapy typically mimics RLS therapy, the primary focus of this review is therapy for idiopathic RLS.
进行了系统的文献回顾和荟萃分析（在适当的情况下），以更新先前 AASM 关于 RLS 和 PLMD 的治疗方法（包括多巴胺能和其他治疗方法）的实践参数。自上次审查以来，已经发表了大量文献，需要更新相应的实践参数。具有标准推荐级别的治疗方法包括普拉克索和罗匹尼罗。具有指南推荐级别的治疗方法包括左旋多巴与多巴胺脱羧酶抑制剂、阿片类药物、加巴喷丁恩卡他和卡麦角林（其使用有额外的注意事项）。具有选择推荐级别的治疗方法包括卡马西平、加巴喷丁、普瑞巴林、可乐定和对于铁蛋白水平低的患者，补充铁剂。由于心脏瓣膜损伤的风险，委员会建议反对使用培高利特。讨论了继发于 ESRD、神经病变和浅静脉功能不全的 RLS 的治疗方法。最后，回顾了 PLMD 的治疗方法。然而，应该提到的是，由于 PLMD 的治疗方法通常模仿 RLS 的治疗方法，因此本次审查的主要重点是特发性 RLS 的治疗方法。
