Gabapentin for RLS Patients

Gabapentin is an epilepsy drug, a form of which is sometimes prescribed for severe cases of restless leg syndrome.  It is a GABA (Gamma-Aminobutyric acid) analogue.  GABA is a major neurotransmitter in the brain. Gabapentin is sold under the brand name Neurontin (and Fanatrex and other brands) and is employed for headache pain in addition to epilepsy.  

The drug company XenoPort Inc markets gabapentin enacarbil, a prodrug that turns into gabapentin inside the body, under the brand name Horizant®. Giving the patient the drug in this form overcomes some of the imitations that gabapentin used as an epilepsy drug has in treatment of RLS: namely short half-life and variable bioavailability.

The FDA approved gabapentin enacarbil for RLS in 2011.  Other forms of gabapentin are not labeled for RLS. These are pills that are taken in the evening.  Dosage is 600 mg of gabapentin enacarbil.

Several clinical trials around the world have found gabapentin
enacarbi helps with RLS and is tolerated within reason.  A big study published in 2010 concluded the drug could be useful for people with moderate to severe RLS for as long as nine months. Another study found it worked well as long as a year.

An Austrian study purported to look at gabapentin versus ropinirole for RLS but concluded that they both work.  Neither was said to be better than the other.

A Spanish study found that not only does gabapentin enacarbil help relieve RLS symptoms, but it also helps sleep architecture.

Gabapentin is classified as an alpha-2 delta drug because it binds to a protein important in the calcium channel.

There are many potential side effects.  Bad ones include swelling in the head area, rash, and hoarseness.  It can also cause changes in mental health in a small number of people.  Be sure to mention side effects to the prescribing doctor.

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