P Laura M Botta, E Samantha S Anguizola, Castro-Villacañas Andrea, Garcia-Borreguero Diego
European Sleep Institute, Luis Pasteur 5607 Vitacura, Santiago, Chile.
European Sleep Institute, Edif. Habitats Plaza, Calle 51, Distr, Panamá.
Sleep Med Clin. 2021 Jun;16(2):269-277. doi: 10.1016/j.jsmc.2021.02.003. Epub 2021 Apr 15.
For a long time, dopaminergic treatment (DT) was the medication for restless legs syndrome. Although DT is effective and safe over the short-term, complications develop over longer periods, including augmentation, tolerance, and impulse control disorders. Nowadays, it is recommended that first-line treatment should be alpha-2 ligands, which are more effective in the absence of previous DT. As a second-line treatment, opioids, such as oxycodone extended-release with naloxone, are approved in Europe. Brain iron should be monitored before and during treatment and corrected if necessary. Two new promising non-DTs are being developed: perampanel and dipyridamole. More research is needed.
长期以来，多巴胺能治疗（DT）一直是治疗不宁腿综合征的药物。尽管DT在短期内有效且安全，但长期使用会出现并发症，包括症状加重、耐受性和冲动控制障碍。如今，建议一线治疗应使用α-2配体，在未进行过DT治疗的情况下，α-2配体更有效。作为二线治疗，阿片类药物，如含纳洛酮的缓释羟考酮，在欧洲已获批准。治疗前和治疗期间应监测脑铁水平，必要时进行纠正。两种有前景的新型非DT药物正在研发中：吡仑帕奈和双嘧达莫。还需要更多的研究。
