A 60-year-old with restless legs syndrome has taken ropinirole for three years. Symptoms now start at 4 pm, spread to the arms and intensify as the

Question

A 60-year-old with restless legs syndrome has taken ropinirole for three years. Symptoms now start at 4 pm, spread to the arms and intensify as the dose is increased. Which intervention best addresses the medication-related complication?

Accepted Answer

Gradually reduce ropinirole and transition to an alpha-2-delta ligand after iron assessment

Answer

Replace ropinirole with a stimulant because augmentation is caused by daytime somnolence

Answer

Increase ropinirole until symptoms are suppressed throughout the afternoon and evening

Answer

Add daytime levodopa while retaining the existing ropinirole dose and schedule

Answer

Continue treatment unchanged because spread to the arms is typical disease progression

RLS – Dopaminergic Augmentation — SCE Neurology MCQ

A 60-year-old with restless legs syndrome has taken ropinirole for three years. Symptoms now start at 4 pm, spread to the arms and intensify as the dose is increased. Which intervention best addresses the medication-related complication?