Condition

Restless Legs Syndrome

Uncontrollable urge to move legs

356.1M
People Affected
60
Active Trials
10.7M
New Cases/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Oral Iron Supplementation (effective if iron deficient)
90% Effectiveness• 90% Confidence• 85% Safety• 30 trials• 5K participants
HIGH EvidenceExcellent ValueDose: Ferrous sulfate 325 mg daily or every other day (with Vitamin C)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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Tylenol💊
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85
DangerousModerateSafe

Time to Effect

4-12 weeks

Duration

3-6 months then maintenance

Response Rate

80%

Remission Rate

50%

Number Needed to Treat (NNT)

3

Common Side Effects:

Constipation: 20%
Nausea: 10%
Abdominal pain: 8%

Annual Cost of Care

Drug Cost

$90

Monitoring

$400

Side Effects

$20

Total Annual

$510

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.4

ICER

$1,000/QALY

Cost per Remission

$1,020

Cost per Responder

$638

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+90%
Response Rate
+80%
Remission Rate
+50%
Common Side Effects
Constipation
+20%
Nausea
+10%
Abdominal pain
+8%

Clinical Trial Phases:

Phase 4
2
Pramipexole
80% Effectiveness• 90% Confidence• 58% Safety• 30 trials• 5K participants
HIGH EvidenceExcellent ValueDose: 0.125-0.5 mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
58
DangerousModerateSafe

Time to Effect

1-3 days

Duration

lifetime

Response Rate

70%

Remission Rate

25%

Number Needed to Treat (NNT)

4

Common Side Effects:

Nausea: 15%
Somnolence: 15%
Dizziness: 10%
Augmentation (long-term): 30%

Annual Cost of Care

Drug Cost

$180

Monitoring

$300

Side Effects

$50

Total Annual

$530

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$10,000/QALY

Cost per Remission

$2,120

Cost per Responder

$757

Treatment Outcomes
Primary Outcomes
IRLSSG Rating Scale (IRLS) Score25/40 points
-52% (-13 points)
RLS Severity (Patient-rated daily symptom scale)3.5/5 points
-40% (-1.4 points)
RLS Sleep Disturbance Scale Score18/30 points
-35% (-6.3 points)
Secondary Benefits
Restless Legs Syndrome Quality of Life (RLS-QoL) Score50/100 points
+20% (+10 points)
Epworth Sleepiness Scale (ESS) Score14/24 points
-30% (-4.2 points)
Periodic Limb Movement in Sleep (PLMS) Index35 events/hour
-25% (-8.75 events/hour)
Common Side Effects
Nausea
+15%
Somnolence
+15%
Dizziness
+10%

Clinical Trial Phases:

Phase 3Phase 4
3
Pregabalin
78% Effectiveness• 90% Confidence• 62% Safety• 7 trials• 4K participants
HIGH EvidenceExcellent ValueDose: 150-450 mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
62
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

72%

Remission Rate

30%

Number Needed to Treat (NNT)

4

Common Side Effects:

Dizziness: 25%
Somnolence: 20%
Weight gain: 7%

Annual Cost of Care

Drug Cost

$360

Monitoring

$300

Side Effects

$50

Total Annual

$710

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.25

ICER

$25,000/QALY

Cost per Remission

$2,367

Cost per Responder

$979

Treatment Outcomes
Primary Outcomes
IRLSSG Rating Scale Score22/40 points (higher indicates more severe symptoms)
-54.5% (-12 points)
Restless Legs Syndrome Quality of Life (RLSQoL) Score55 points (higher indicates worse quality of life)
-32.7% (-18 points)
Pittsburgh Sleep Quality Index (PSQI) Score14/21 points (higher indicates worse sleep quality)
-28.6% (-4 points)
Secondary Benefits
Periodic Limb Movement in Sleep (PLMS) Index45 events/hour
-55.6% (-25 events/hour)
Wake After Sleep Onset (WASO)80 minutes
-37.5% (-30 minutes)
Pain Numeric Rating Scale (NRS) Score6/10 points (where 0=no pain, 10=worst possible pain)
-33.3% (-2 points)
Common Side Effects
Dizziness
+25%
Somnolence
+20%
Weight gain
+7%

Clinical Trial Phases:

Phase 3Phase 4
4
Ropinirole
78% Effectiveness• 90% Confidence• 58% Safety• 25 trials• 5K participants
HIGH EvidenceExcellent ValueDose: 0.25-4 mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
58
DangerousModerateSafe

Time to Effect

1-3 days

Duration

lifetime

Response Rate

70%

Remission Rate

25%

Number Needed to Treat (NNT)

4

Common Side Effects:

Nausea: 15%
Somnolence: 15%
Dizziness: 10%
Augmentation (long-term): 30%

Annual Cost of Care

Drug Cost

$180

Monitoring

$300

Side Effects

$50

Total Annual

$530

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$10,000/QALY

Cost per Remission

$2,120

Cost per Responder

$757

Treatment Outcomes
Primary Outcomes
IRLS Score25/40 points
-40% (-10 points)
Nights with RLS Symptoms per Week5.5 nights per week
-27.3% (-1.5 nights/week)
Patient Global Impression of Severity (PGIS) Score4/5 points
-37.5% (-1.5 points)
Secondary Benefits
RLS Quality of Life Scale Score60/100 points
-30% (-18 points)
Sleep Latency45 minutes
-26.7% (-12 minutes)
Wakefulness After Sleep Onset (WASO)90 minutes
-27.8% (-25 minutes)
Common Side Effects
Nausea
+15%
Somnolence
+15%
Dizziness
+10%

Clinical Trial Phases:

Phase 3Phase 4
5
Rotigotine
77% Effectiveness• 88% Confidence• 57% Safety• 23 trials• 2K participants
HIGH EvidenceModerate ValueDose: 1-3 mg/24 hours patch daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
57
DangerousModerateSafe

Time to Effect

1-3 days

Duration

lifetime

Response Rate

68%

Remission Rate

22%

Number Needed to Treat (NNT)

5

Common Side Effects:

Application site reactions: 15%
Nausea: 15%
Somnolence: 12%
Augmentation (long-term): 30%

Annual Cost of Care

Drug Cost

$9,000

Monitoring

$300

Side Effects

$100

Total Annual

$9,400

Cost-Effectiveness

MODERATE

QALYs Gained

0.2

ICER

$100,000/QALY

Cost per Remission

$41,778

Cost per Responder

$13,926

Treatment Outcomes
Primary Outcomes
IRLSSG Rating Scale Total Score28 points (0-40 scale, higher is worse)
-50% (-14 points)
Periodic Limb Movements in Sleep (PLMS) Index35 movements/hour
-57.1% (-20 movements/hour)
Wakefulness After Sleep Onset (WASO)95 minutes
-42.1% (-40 minutes)
Secondary Benefits
Restless Legs Syndrome Quality of Life (RLS-QoL) Total Score58 points (0-100 scale, higher is worse)
-34.5% (-20 points)
Epworth Sleepiness Scale (ESS) Score13 points (0-24 scale, higher is more sleepy)
-30.8% (-4 points)
Pittsburgh Sleep Quality Index (PSQI) Global Score15 points (0-21 scale, higher is worse sleep quality)
-33.3% (-5 points)
Common Side Effects
Application site reactions
+15%
Nausea
+15%
Somnolence
+12%

Clinical Trial Phases:

Phase 3Phase 4
6
Gabapentin Enacarbil
75% Effectiveness• 88% Confidence• 62% Safety• 26 trials• 3K participants
HIGH EvidencePoor ValueDose: 600-1200 mg once daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
62
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

68%

Remission Rate

22%

Number Needed to Treat (NNT)

5

Common Side Effects:

Somnolence: 25%
Dizziness: 20%
Nausea: 8%

Annual Cost of Care

Drug Cost

$7,200

Monitoring

$300

Side Effects

$50

Total Annual

$7,550

Cost-Effectiveness

POOR

QALYs Gained

0.25

ICER

$180,000/QALY

Cost per Remission

$34,318

Cost per Responder

$11,103

Treatment Outcomes
Primary Outcomes
International Restless Legs Syndrome Study Group (IRLSSG) Total Score25.0 points (Scale: 0-40)
-44% (-11.0 points)
Clinical Global Impression-Severity (CGI-S) Score4.5 points (Scale: 1-7)
-22.2% (-1.0 points)
MOS Sleep Scale - Sleep Problems Index I65.0 points (Scale: 0-100)
-23.1% (-15.0 points)
Secondary Benefits
Restless Legs Syndrome Quality of Life (RLSQoL) Questionnaire Score55.0 points (Scale: 0-100)
-21.8% (-12.0 points)
Wake Time After Sleep Onset (WASO)100 minutes
-25% (-25 minutes)
Pittsburgh Sleep Quality Index (PSQI) Global Score14.0 points (Scale: 0-21)
-28.6% (-4.0 points)
Common Side Effects
Somnolence
+25%
Dizziness
+20%
Nausea
+8%

Clinical Trial Phases:

Phase 3Phase 4