Bupropion as a Possible Treatment Option for Restless Legs Syndrome

Objective: To describe a case of restless legs syndrome (RLS) successfully managed with bupropion. Case Summary: A 45-year-old female presented to a Veterans Affairs primary care clinic with a history of chronic insomnia. Her complicated history of treatment failure to sedative–hypnotic agents, continued sleep disturbances, and complaints of intolerable leg sensations fostered collaboration between a psychiatrist and pharmacist to identify effective treatment. Further review of her medical history and subjective complaints led to a diagnosis of RLS. Based on this new diagnosis, she was prescribed several Food and Drug Administration–approved and alternative agents recommended for the management of RLS. Unfortunately, each medication resulted in a variety of intolerable adverse effects, limiting the list of treatment options. Although not widely used for RLS, bupropion XL (Wellbutrin XL) 150 mg daily was initiated, resulting in resolution of RLS within 3 days. Discussion: RLS can be an extremely disabling disorder and affects many people. For most patients, dopamine agonists are the treatment of choice for symptomatic relief. However, for patients unable to tolerate this drug class, small trials and case reports have identified alternative agents. This case supports findings from other cases suggesting a beneficial response with bupropion for the management of RLS. Conclusion: Bupropion may be a treatment option for patients who have RLS and are unable to tolerate dopamine agonists.