Current Treatment of Willis Ekbom Disease

Abstract

Willis Ekbom Disease (WED) is one of sleep related movements disorders, which is commonly encountered. The treatment of WED has showed many alterations over time. L-dopa is the first dopaminergic agent used to treat to WED, but its use is limited due to adverse effects such as augmentation. Dopamin agonists are the first option in the treatment of WED. These agents are thought to cause less augmentation compared to L-dopa. Of these agents, today, ropinirole, pramipexole and rotigotine have FDA approval. Excessive daytime sleepiness and impulsive control disorders are among important adverse effects. Other agents used to treat WED are alpha 2 delta ligands such as gabapentin, gabapentin enacarbil and pregabalin. Of these, only gabapentin enacarbil has FDA approval for the treatment of WED. Although there are several case reports, augmentation has not been demonstrated related to alpha 2 delta ligands in long term controlled studies. In secondary WED cases, treatment of associated medical conditions also leads to great improvements in WED symptoms.