Yoga versus educational film intervention in restless legs syndrome: extension of trial may be beneficial to patients

摘要

The article by Innes et al, “Effects of a 12-week yoga versus a 12-week educational film intervention on symptoms of restless legs syndrome and related outcomes: an exploratory randomized controlled trial,” is interesting. As the authors point out, medications used in the management of restless leg syndrome (RLS) carry risk of serious side effects (affecting 6%-80% of patients), and most of these medications cannot be used in patients who are pregnant or in the 6 months postpartum period. However, the study excluded pregnant patients and patients within 6 months postpartum period. Even though clinical drug trials do exclude pregnant and postpartum patients because of teratogenicity and other side effects, not including pregnant and postpartum women in nonpharmacological trials is not rational. Women with RLS are more likely to have hypertensive disorder of pregnancy. Some non-first-line drugs such as clonazepam, clo-nidine, and opioids may be justified depending on severity. Neonatal withdrawal is a concern with these drugs, especially because RLS disease is more prevalent in late pregnancy. Some drugs that may be teratogenic are not used in pregnancy. Considering these situations, it is even more important to include pregnant patients and patients within 6 months of the postpartum period.