Idiopathic restless legs syndrome treatment: Progress and pitfalls?

The pathophysiology of Restless Legs Syndrome (RLS) remains uncertain. Although the dopaminergic and/or the iron breakdown homeostasis hypotheses are still considered to be the mainstay of the RLS underlying mechanism, therapeutic intervention aiming to alleviate RLS syndrome through dopamine agonists use and iron stores recovery failed so far to show short-term remarkable efficacy, and controlled trials to establish sustained long-term efficacy, tolerability and safety are lacking. Here we review available literature dealing with pharmacological treatment of RLS and consider some rational aspects of RLS pathophysiology that may support the use of available drug classes in treating this condition.