Restless legs症候群の診断と新規治療法―Ⅱ．治療

Diagnosis and Novel Treatment Approaches in Restless Legs Syndrome: II. Treatment

Ⅴ．治療法

　治療のアルゴリズム（Fig.1）を適用するにあたり，restless legs症候群（RLS）には当然のことながら症状に軽重があり，また，頻度的にも必ずしも毎日は症状のない間欠性RLSと毎日症状のある持続性RLSがあることを考慮する必要がある。また，治療には非薬物療法と薬物療法があり，軽症では，前者のみで寛解することもありうる。以下に代表的な非薬物療法と薬物療法を述べる。

Abstract

　The symptoms of restless legs syndrome (RLS) can be managed effectively by treatment. The pathophysiology of primary RLS is only partly understood; however, a strong association with brain iron deficiency, which possibly impairs dopaminergic function, has been identified.

　Dopamine agonists are the mainstay of RLS treatment, but other therapies, including gabapentin, benzodiazepines, and low-potency opioids, are also commonly employed. Recent evidence-based guidelines recommend dopamine agonists or alpha-2-delta ligands as the first-line treatment for RLS depending on patients' clinical background, comorbidity, and severity of the symptoms. In this review, we focus on the pathophysiology, comorbidity, differential diagnosis, and novel treatment approaches of RLS.