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Benzodiazepines for restless legs syndrome

Background

Restless legs syndrome (RLS) is a common disease affecting about 5% to 15% of the population. Symptoms of RLS can be severe in a minority of and can have a major impact on sleep, mostly sleep initiation, and quality of life. Benzodiazepines are drugs that can induce and maintain sleep and, hence, intuitively are thought to be beneficial to people with RLS. Altough benzodiazepines, particularly clonazepam, are used to treat RLS symptoms, a systematic review done by the American Academy of Sleep Medicine stated that benzodiazepines should not be used as a first‐line treatment, although could be used as a coadjuvant therapy.

Objectives

To evaluate the efficacy and safety of benzodiazepine compared to placebo or other treatment for idiopathic RLS, including unconfounded trials comparing benzodiazepines versus open control.

Search methods

In March 2016 we searched CENTRAL, MEDLINE, Embase and LILACS We checked the references of each study and contacted study authors to identify any additional studies. We considered studies published in any language.

Selection criteria

Randomised clinical trials of benzodiazepine treatment in idiopathic RLS.

Data collection and analysis

We did not perform data collection and analysis, since we did not include any studies,

Main results

We did not identify any studies that met the inclusion criteria of the review. Two cross‐over studies are awaiting classification because the cross‐over trials did not give data at the end of the first cross‐over period.

Authors' conclusions

The effectiveness of benzodiazepines for RLS treatment is currently unknown.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

Benzodiazepines for restless legs syndrome

Background

Restless legs syndrome (RLS) is a common and distressing disease affecting 5% to 15% of the population. Many physicians are still unaware of the disease and do not recognize its symptoms. This disease can affect sleep significantly, impairing quality of life. There is a need for safe and effective treatment for RLS. Current treatments include dopamine agonists, anticonvulsants, and opioids.

Question

Are benzodiazepines effective and safe for people with RLS?

Methods

We searched the literature for studies in any language, published or not, that considered benzodiazepines for the treatment of RLS.

Results

No studies were included in the review.

Discussion

Benzodiazepines have been used for a long time in people with RLS, because these drugs help sleep initiation and maintenance. As there was no properly conducted systematic review on the effectiveness of benzodiazepines, we performed one on this topic.

Conclusion

This systematic review shows that there is no good data to support or refute the use of benzodiazepines to treat symptoms of RLS.