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For further information, see CMDT Part 24-13: Movement Disorders
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Affects 1–5% of people
May occur as a primary (idiopathic) disorder or in relation to
May have a hereditary basis, and several genetic loci have been associated with the disorder
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Restlessness and curious sensory disturbances lead to an irresistible urge to move the limbs, especially during periods of relaxation
Disturbed nocturnal sleep and excessive daytime somnolence
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Oral iron sulfate in patients with ferritin levels ≤ 75 mcg/L (13.4 mcmol/L) should be attempted prior to initiation of other pharmacotherapies
Pramipexole (0.125–0.5 mg orally once daily), ropinirole (0.25–4 mg orally once daily) 2–3 hours before bedtime, or rotigotine (1–3 mg/24h transdermal patch once daily), or with gabapentin enacarbil (300–1200 mg orally each evening)
Gabapentin (starting with 300 mg orally daily, increasing to approximately 1800 mg orally daily depending on response and tolerance)
Pregabalin (150–300 mg orally divided twice to three times daily)
Levodopa
Extended release oxycodone-naloxone (5 mg-2.5 mg to 10 mg-5 mg orally twice daily) is useful in patients with severe symptoms or those who are refractory to first-line therapies