Evaluate for and treat underlying conditions that can exacerbate RLS • Iron Deficiency • OSA, PLMS • CKD, ESRD • Alcohol, caffeine, antihistaminergic, serotonergic, antidopaminergic medications
Check iron status and supplement iron if indicated
Strong recommendation for alpha-2-delta ligands as first line therapies for RLS • Gabapentin enacarbil, Gabapentin, Pregabalin
Move away from using dopaminergic drugs (pramipexole, ropinirole, rotigotine) as first line agents due to risk of augmentation.
New Non-pharm treatment: high-frequency peroneal nerve stimulation
