Dopamine and Medication

Restless legs syndrome probably involves a disruption in the production of the substance dopamine. This causes a shortage. Dopamine is a neurotransmitter. To gain more insight into the effect of this substance, I delved a little deeper into the matter.

In this blog I will discuss the following:

  1. What are neurotransmitters?
  2. Which medication is available for a dopamine deficiency?
  3. What are the possible side effects?

I myself have no experience with taking medication for restless legs. I have read a lot of stories from fellow sufferers about this though. For the time being, partly because of this, I have come to the conclusion that I want to postpone medication use for as long as possible.

Neurotransmitters in short

Neurotransmitters are substances that transmit signals in the brain between nerve cells or between muscle cells. Well-known neurotransmitters are serotonin, adrenaline and dopamine. These mainly affect your state of mind.

  • Serotonin has to do with self-confidence – and a lack of it when this neurotransmitter is under-produced.
  • Adrenaline provides instant energy when danger threatens and it is necessary to take immediate action.
  • Dopamine is a kind of reward system in which substances are released in activities that give pleasure and joy.

It is said that a dopamine level that is too low makes it more difficult to control muscles. For example, this can lead to muscle stiffness, slow movement and strong shaking, such as in Parkinson’s disease.

Although the exact cause is unknown, it is believed that dopamine deficiency can also lead to restless leg syndrome.


Unfortunately, no drug has been found to cure restless legs syndrome. However, there are medications that can ease its symptoms. Some drugs specifically target dopamine.

In the past, mainly Levodopa (or Carbidopa) was prescribed. This medicine contains a chemical that the body uses to make dopamine. However, when used by patients with restless legs, it turned out to have (too) many unpleasant side effects.

Nowadays, therefore, preference is given to so-called dopamine agonists. These drugs mimic the action of dopamine. The brain is supposedly fooled by it and “thinks” that enough dopamine is being produced.

The website of Farmacotherapeutisch Kompas states that dopamine agonists ensure that complaints of restless legs are reduced. There are fewer interruptions to sleep and the amount of sleep increases.

Normally dopamine agonists are prescribed for Parkinson’s disease. People dealing with restless legs receive a lighter dose, and then only if they have really serious complaints.

Variants of dopamine agonists are:

  • Pramipexol
  • Ropinirol
  • Rotigotine

Pramipexol and Ropinirol are presented in pill form. These are best taken about two hours before the symptoms of restless legs start. Rotigotine comes in the form of a patch that is stuck to the skin. For all three of these dopamine agonists, the dosage is gradually increased.

Side effects

Dopamine agonists sometimes have side effects, but these are usually mild. According to DokterOnline, some of the most common side effects are:

  • Nausea
  • Dizziness
  • Fatigue
  • Headache

More than half of the patch users have a skin reaction.

The side effects usually pass after 10 to 14 days. Incidentally, if you stop taking the medication too quickly, you have to take withdrawal symptoms into account.

What unfortunately often occurs when using dopamine agonists is augmentation. This means that a person has a worsening of symptoms, even after increasing the dose. This is the case with between 50 and 70% of the users within 10 years. The symptoms often become worse than before the use of medication. For some, the medicines work less long than before. The complaints may start earlier in the day or there is a spread of the complaints to the arms or trunk.

The cause of augmentation is unknown. However, a connection is suspected with a shortage of iron. There are studies that suggest that people with restless legs need more iron than the recommended daily amount.

Do you have experience with augmentation?

7 thoughts on “Dopamine and Medication”

  1. 15 jaar geleden was mijn neuroloog nog onbekend met augmentatie. Op advies van een lotgenoot ben ik toen begonnen met oxycodon en heb dit conform het advies op het farmacomtherapeutisch compas opgehoogd. De arts was het er mee eens.

  2. Bij de eerste augmentatie heb ik een oproep gedaan op een forum van de stichting restless legs. Een lotgenoot gaf het advies om oxycodon te proberen. Mijn neuroloog gaf mij het recept. Conform het farmacotherapeutisch compas heb ik de dosering opgehoogd tot 60 mg per dag. Op advies van de neuroloog heb ik het daarna weer afgebouwd en ben ik weer begonnen met pramipexol.

  3. Bij mij is het niet erfelijk. Ik heb het al vanaf mijn 30ste jaar. Ik gebruik al 25 jaar ropinerol en dat gaat redelijk. Ik heb nog nooit augmentatie gehad.

    • Hoeveel MG per pil en hoeveel pillen gebruik je per dag en ook welke tijden? . Zelf gebruik ik 2 pillen van 1 mg . Gr jan

  4. Ik heb 2x augmentatie gehad, telkens na 8 jaar. De eerste keer was een ware hel, omdat nog onvoldoende bekend was hoe men hiermee moet omgaan. De oplossing was stoppen met pramipexol, oxycodon opbouwen totdat de klachten verdwijnen (60 mg per dag) en na 3 maanden weer beginnen met pramipexol en oxycodon afbouwen

    • Dag Nora,
      Heb je dit in samenwerking met een arts gedaan, of ben je er zelf achter gekomen dat deze manier je helpt?
      Thnx alvast!

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