Benzodiazepines significantly decrease the total number of abnormal leg movements during rest.
Benzodiazepines are a class of drugs that interfere with chemical activity in the nervous system and brain, serving to reduce communication between nerve cells. As a result, such medications may promote sleep, relieve anxiety, reduce restlessness, and relax muscles.
Therapy with benzodiazepines improves sleep and reduces arousals from PLMS. This class of drugs may be less effective in eliminating movement and sensory abnormalities associated with RLS. However, in some severely affected patients, benzodiazepines significantly decrease the total number of abnormal leg movements during rest.
Overall, long-term nightly benzodiazepine therapy has been shown to remain effective with a low risk of adverse side effects, tolerance, or abuse. Such therapy may be most helpful in those with mild or intermittent symptoms, particularly for young individuals. In those with severe symptoms, benzodiazepine therapy may be effective when used in combination with carbidopa/levodopa or dopamine agonists.
The benzodiazepine Clonazepam (Rivotril®) is often prescribed for the treatment of RLS. Other benzodiazepines that may be recommended as appropriate, suitable alternatives include Temazepam (Normison®), Diazepam (Valium®) and Triazolam (Halcion®).
Benzodiazepines are taken by mouth prior to bedtime as needed. Average dosages for the treatment of RLS may range from 0.5 to 2.0-mg/day clonazepam, 7.5 to 30.0 mg/day temazepam, 5.0 to 15.0 mg/day diazepam, or 0.125 to 0.5 mg/day triazolam.
Potential adverse effects associated with the use of benzodiazepines include morning drowsiness (somnolence), decreased sexual desire (libido), and a risk of falls during the night (particularly in elderly individuals). These medications may also result in obstructive sleep apnea or aggravate this condition if it is preexisting. It is also important to note that, depending upon dosage levels and other factors, benzodiazepines may result in dependency. However, there is usually a low risk for such benzodiazepine tolerance or dependency in individuals receiving long-term therapy. These medications should not be taken in combination with alcohol nor with other medications that have a depressant effect on the central nervous system.
