ABSTRACT
In RLS, initially there is often a dramatic response to treatment with dopamine agonists or levodopa. However, this beneficial response may not be sustained. One complication, thought to arise from dopaminergic drug administration, appears to be augmentation, first recognized by Allen and Early in 19961. They reported that 82% of their patients treated with a night-time dose of levodopa/carbidopa over a period of 2 months reported that RLS symptoms had increased in late afternoon and early evening. The symptoms were severe in some cases and required a change in medication. In general, it is now recognized that augmentation complicates about 80% of patients with RLS on chronic levodopa treatment. Clinically, augmentation may start about 3-4 weeks after starting treatment and this is accompanied by an increase in symptom severity or a decrease in drug efficacy. Increasing doses of levodopa may lead to increasing augmentation, and discontinuation of treatment unmasks the symptoms of RLS. However, augmentation usually resolves on withdrawal of the drug.
