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Restless Legs Syndrome: Underdiagnosed & Undertreated

neuroscienceCME Multimedia Snack

Premiere Date: Thursday, December 6, 2012
December 6, 2012

This activity offers CE credit for:

1. Physicians (CME)
2. Pharmacists (ACPE)
3. Other

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Friday, December 6, 2013
Note: Credit Is No Longer Available

Faculty

Charles B. Nemeroff, MD, PhD (Moderator) Professor and Chair Department of Psychiatry Mulva Clinic for the Neurosciences Director, Institute of Early Life Adversity Research Dell Medical School The University of Texas at Austin Austin, TX

W. Vaughn McCall, MD, MS  Case Distinguished University Chair Department of Psychiatry and Health Behavior Executive Vice Dean Medical College of Georgia Augusta University Augusta, GA

Statement of Need

Restless legs syndrome (RLS), a sensorimotor disorder, spans the boundaries of neurology, sleep medicine, and psychiatry. Although common, this life-altering condition is often unrecognized and undiagnosed, leaving patients with a decreased quality of life. The diagnosis of RLS is clinical and does not require polysomnographic findings. The dysesthesias of RLS are associated with an urge to move; the dysesthesias and urge to move are relieved by movement and are worse in the evening and at night.(1)

Specific groups of individuals are at increased risk for developing RLS, including those with peripheral neuropathy, diabetes, low iron stores (evidenced by low serum ferritin concentrations), or uremia and people who are taking psychotropic medications.

A variety of effective pharmacological treatments, including four drugs approved for the treatment of moderate to severe RLS by the U.S. Food and Drug Administration (gabapentin enacarbil, pramipexole, ropinirole, and rotigotine) are now available, yet recently released guidelines(2) on their use are not widely disseminated.

This neuroscienceCME Snack will assist the learner in recognizing the signs and symptoms of RLS, selecting appropriate assessment tools, and planning therapy.

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1. Allen RP, Picchietti D, Hening WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med. 2003;4(2):101-119. PMID: 14592341.
2. Aurora RN, Kristo DA, Bista SR, et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults-an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine clinical practice guideline. Sleep. 2012;35(8):1039-1062. PMID: 22851801.

Activity Goal

To educate clinicians about the diagnosis and FDA-indicated treatments for restless legs syndrome.

Learning Objectives

At the end of this CE activity, participants should be able to:

• Increase the level of clinical suspicion for restless legs syndrome (RLS) in patients who present with sensory sleep complaints in the legs and use an evidence-based approach to diagnose RLS.
• Describe consequences of untreated or under-treated restless legs syndrome (RLS) and implement individualized treatment plans for patients with RLS.

Financial Support

This activity is supported by an educational grant from UCB, Inc.

Target Audience

Primary care physicians, neurologists, sleep physicians, and pharmacists and other health care providers who manage patients with RLS.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME Outfitters, LLC, designates this enduring material for a maximum of .5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CPE Credit (Pharmacists):
CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. .5 contact hours (0.05 CEUs)
Universal Activity Number: 0376-0000-12-031-H01-P (recorded programs)
Activity Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/TST732 (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit www.neurosciencecme.com/technical.asp.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Nemeroff has disclosed that he receives grants/research support from the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH). He serves as a consultant to Eli Lilly and Company; Shire Pharmaceuticals, Inc.; SK Pharma; Roche; Takeda Pharmaceuticals North America, Inc.; and Xhale, Inc. He serves on the scientific advisory boards of the American Foundation for Suicide Prevention (AFSP); Anxiety Disorders Association of America (ADAA); CeNeRx BioPharma; National Alliance for Research on Schizophrenia and Depression (NARSAD); PharmaNeuroBoost; Xhale, Inc.; Skyland Trail; and AstraZeneca Pharmaceuticals (2009). He serves on the board of directors of the American Foundation for Suicide Prevention (AFSP); Gratitude America; Cook Pharma, Inc. (2010); NovaDel Pharma, Inc; and Skyland Trail. He is a stockholder of CeNeRx BioPharma; NovaDel Pharma, Inc., PharmaNeuroBoost; Reevax Pharmaceuticals LLC; and Xhale, Inc. His other financial Interests include CeNeRx BioPharma and PharmaNeuroBoost. He holds patents for the following: method and devices for transdermal delivery of lithium (US 6,375,990B1); method of assessing antidepressant drug therapy via transport inhibition of monoamine neurotransmitters by ex vivo assay (US 7,148,027B2).

Dr. McCall has no disclosures to report

Tony Graphm, MD (peer review) has no disclosures to report.

Catherine Friederich Murray, NASW (planning committee) has no disclosures to report.

Joy Bartnett Leffler, MLA, NASW, CSE (planning committee) has no disclosures to report.

Sandra Haas Binford, MAEd (planning committee) has no disclosures to report.

Sharon Tordoff, CCMEP (planning committee) has no disclosures to report.

Unlabeled Use Disclosure

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

CME Outfitters, LLC, the faculty, and UCB, Inc. do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).