The recent AASM Draft Guidelines

[SueJohnson]

I finally had a chance to look at the recent AASM Draft Guidelines.

I was surprised by a number of things.

They should have had something between conditional for and conditional against.

Why did they choose those particular things? Some don't even have much relevance to improving RLS such as antidepressants.

If they had to list Wellbutrin (bupropion) for example this is where they should have had something between conditional for and conditional against as is shown in Https://pubmed.ncbi.nlm.nih.gov/21737767/ .

Why just oxycodone? Why not all opioids as there are studies on the others including buprenorphine showing they help RLS.

Why strong for IV iron and only conditional for ferrous sulfate? When the Mayo Algorithm says one should try iron first except in 3 conditions.

Why conditional against valerian which helps RLS? pubmed.ncbi.nlm.nih.gov/192...

Why list valoric acid at all? Although it may help RLS that is not what it is normally used for. There are plenty of things that may help RLS that were not listed.

[Debra626]

I watched their entire presentation, and the committee emphasized they ONLY included info from the literature that met certain scientific standards (ex: double blind studies with meds, "objective measures" on symptom improvement such as the International RLS Rating Scale.) But in their discussion, they said lack of evidence of something - for example buprenorphine - didn't mean it wasn't supported or a good choice. I think this is why it seems to be such a strange grouping of medications and recommendations. They called for more research on numerous subjects, including for children that had barely anything.

I'm just relieved the DA are off the list. It's shameful they haven't updated the standards since 2012. They do have a comment period open for the next 4 weeks. We as patients should all reply! aasm.org/aasm-invites-publi...

BTW, I'm now nearly 4 weeks off pramipexole and doing a ton better. My brain seems to know what to do to heal. My comments to AASM will be to help us all get through augmentation, which their recommendations caused. It's a terrible, awful, horrible thing but DOES get better. My best to all. Debra

[SueJohnson in reply to Debra626]

That's great that you are a lot better. I only looked at recommendations in the written report . I didn't realize there was more in the video. Of course the problem is that doctors being busy will just do what I did and not bother to watch the video. I definitely will submit my comments.