Benzodiazepines to Treat Restless Legs Syndrome
You may know benzodiazepines, or benzos, as tranquilizers or sedatives. More than a dozen are available by prescription. These drugs do not treat the symptoms of restless legs syndrome (RLS) but can help someone with RLS get a more restful sleep.1,2
Klonopin (clonazepam) is the benzodiazepine that is the best studied for RLS. Other benzodiazepines include Valium, Xanax, and Ativan.3
Benzodiazepines may be prescribed in small doses for mild RLS, for occasional use. These drugs may also be added on to other RLS treatments.4
Benzodiazepines for restless legs syndrome
Benzodiazepines can help people with RLS sleep better. However, the side effects of benzodiazepines, such as sleepwalking and daytime sleepiness, mean it is not often prescribed for RLS.1,4
Other treatments for restless legs syndrome
There are several ways to treat RLS, including lifestyle changes, devices, prescription drugs, and home remedies. It may take a combination of all of these to reduce the leg sensations and get a good night’s sleep. In general, medicine is most often prescribed only for severe RLS after non-drug options have not worked.
There are 4 prescription drugs approved by the FDA for RLS. However, many other drugs may be prescribed off-label for RLS. Off-label means the drug has been created for a different purpose but may help with some symptoms of another health condition. The drugs prescribed for RLS include:1,4
- Anti-seizure drugs such as gabapentin enacarbil (also called alpha-2-delta calcium channel ligands)
- Dopaminergic agents such as pramipexole, ropinirole, rotigotine
What are the possbile side effects of benzodiazepines?
The most common side effects of benzodiazepines are:4
- Daytime sleepiness or grogginess
- Rebound insomnia (trouble sleeping the next night after using the drug)
At higher doses, these drugs may affect balance and coordination, which can cause accidents and falls. Higher doses may also impact memory and concentration, especially in older people. This is why benzodiazepines may be avoided for use in older patients. People may build up a tolerance after long-term use, which can lead to abuse.4
These are not all the possible side effects of benzodiazepines. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with benzodiazepines.
Things to know about benzodiazepines
Benzodiazepines should not be used in people with RLS who also have sleep apnea.4
You should not use clonazepam if you have glaucoma or liver disease.3
Short-acting sleeping pills such as zolpidem (Ambien, Edlunar, Intermezzo, or Zolpimist) should not be prescribed for RLS. This is due to the high rates of sleepwalking, sleep eating, and sleep driving that may happen.4
Before beginning treatment for RLS, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.