Which of the following medications is not used to treat Restless Legs Syndrome (RLS): Amantadine, Levodopa, Ropinirole, Carbamazepine, or Clonazepam?

From the Guidelines

Amantadine is not a commonly used medication to treat Restless Legs Syndrome (RLS), and the provided evidence does not support its use for this condition.

Medications Used to Treat RLS

• Levodopa may be used to treat RLS in certain cases, but its standard use is not recommended due to the risk of augmentation and other adverse effects 1.
• Ropinirole is a dopamine agonist that may be used to treat RLS, but its standard use is not recommended due to the risk of augmentation and other adverse effects 1.
• Carbamazepine is not recommended for the treatment of RLS due to low certainty of evidence 1.
• Clonazepam is not recommended for the treatment of RLS due to very low certainty of evidence 1. It's essential to note that the American Academy of Sleep Medicine (AASM) provides conditional recommendations against the standard use of certain medications, including levodopa, ropinirole, carbamazepine, and clonazepam, for the treatment of RLS 1. However, amantadine is not mentioned in the provided evidence as a recommended or non-recommended medication for RLS, but based on the options given and the context of the question, it is the most likely answer.

From the Research

Medications Used to Treat Restless Legs Syndrome (RLS)

The following medications are used to treat RLS:

• Levodopa 2, 3
• Ropinirole 4, 5, 2, 3
• Amantadine 5, 2
• Carbamazepine 2
• Clonazepam 2, 6

Medication Not Typically Used as a First-Line Treatment for RLS

• Clonazepam is not typically used as a first-line treatment for RLS, although it may be used as a coadjuvant therapy 6

Medications Considered Efficacious or Likely Efficacious for RLS

• The following medications are considered efficacious for RLS: levodopa, ropinirole, pramipexole, cabergoline, pergolide, and gabapentin 2
• The following medications are considered likely efficacious for RLS: rotigotine, bromocriptine, oxycodone, carbamazepine, valproic acid, and clonidine 2

Conclusion Regarding the Question

Based on the provided evidence, Amantadine is considered investigational for the treatment of RLS 2, but it has been compared to ropinirole in a clinical trial and shown to be effective until week 8 5. However, the question asks which medication is not used to treat RLS. Given the information provided, all the medications listed (Amantadine, Levodopa, Ropinirole, Carbamazepine, and Clonazepam) have been used to treat RLS in some capacity. However, Clonazepam is the least supported as a first-line treatment option 6.