American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the first-line treatment for Restless Legs Syndrome?

1. Dopamine agonists

2. Antidepressants

3. Opioids

4. Antihistamines

The correct answer is: Dopamine agonists

The first-line treatment for Restless Legs Syndrome (RLS) is dopamine agonists. These medications work by stimulating dopamine receptors in the brain, which can help reduce the uncomfortable sensations and urge to move that characterize RLS. Dopamine is a crucial neurotransmitter involved in regulating movement, and increasing its activity can alleviate symptoms effectively. Research and clinical guidelines support the use of dopamine agonists such as pramipexole and ropinirole as they provide significant symptomatic relief and improve the quality of life for individuals suffering from this condition. Other treatments may be effective as well but are typically not considered first-line for RLS management. While antidepressants and opioids are effective for managing other conditions, their role in RLS is limited. Antihistamines may help with sleep but do not address the core symptoms of RLS, making them less suitable as a primary treatment option. Therefore, the use of dopamine agonists is the most appropriate and evidence-based first-line approach for patients with Restless Legs Syndrome.