Restless Legs Syndrome (RLS) is a distressing neurological condition that can severely impact daily life. For many, effective treatment is essential—but when that treatment is mismanaged, the consequences can be devastating.

At Switalskis, we have supported several clients who have suffered due to failings in the treatment of RLS. A key concern we frequently encounter is the way dopamine agonist medications are prescribed and the lack of warnings about their serious side effects. One such case is that of Mrs Susan Mason, whose life was profoundly affected by the consequences of inappropriate treatment.

The case of Susan Mason

Mrs Mason was diagnosed with RLS in 2014. Her GP arranged a blood test, including a check of her serum ferritin levels, which were found to be borderline. At this stage, she was not offered treatment and managed her symptoms without medication.

By early 2018, Mrs Mason’s symptoms had worsened, prompting her to return to her GP. However, this time, no serum ferritin test was carried out, and she was prescribed pramipexole, a dopamine agonist. Crucially, she was not informed of the serious side effects associated with this medication, including impulse control disorders such as compulsive gambling. Nor was she advised about alternative treatment options.

By June 2019, Mrs Mason began to experience troubling side effects, including increased spending and gambling. She raised these concerns with her GP, who decided to switch her medication—but instead of stopping dopamine agonists altogether, she was prescribed ropinirole, another drug in the same class. For a period, she was even taking both medications at the same time.

Her medical records show that she repeatedly told her GP that she was struggling with gambling urges. Yet at no point was she informed that this was a known side effect of her medication. Unaware of the connection, Mrs Mason continued to suffer the financial and emotional consequences of compulsive gambling.

It was only after conducting her own research that Mrs Mason discovered the link between dopamine agonists and impulse control disorders. Determined to take back control, she gradually reduced and then stopped the medication—at which point, her gambling urges completely disappeared.

A subsequent blood test in December 2020 showed that her serum ferritin levels were low. She was prescribed an iron supplement, which significantly improved her RLS symptoms—meaning that the dopamine agonist medication had never been necessary in the first place.

How Switalskis clinical negligence team helped

Mrs Mason instructed Kimberley Bradfield, Associate Solicitor, to investigate the treatment she had received. A GP expert reviewed her medical records and identified clear breaches of duty, including:

Failure to check serum ferritin levels in March 2018, before prescribing dopamine agonists, despite NHS Clinical Knowledge Summaries (CKS) guidance stating that this is essential.

Failure to check serum ferritin levels again in June 2019, when Mrs Mason’s symptoms had worsened.

Failure to recognise and address the gambling side effects of pramipexole, leading to an inappropriate prescription of ropinirole, another dopamine agonist with the same risks.

The British National Formulary (BNF) clearly states that dopamine-receptor agonists are linked to impulse control disorders, including pathological gambling, binge eating, and hypersexuality. Patients should be warned about these risks, and switching from one dopamine agonist to another does not eliminate the side effects. Mrs Mason’s case showed that these guidelines were not followed.

A Letter of Claim was submitted, alleging that had Mrs Mason’s serum ferritin been tested in 2018, she would likely have been given an iron supplement instead of dopamine agonists. On the balance of probabilities, this would have eased her RLS symptoms, avoiding the devastating gambling side effects entirely.

While the Defendants disputed the need for a serum ferritin test, they admitted that it was a breach of duty to prescribe ropinirole in 2019, given that Mrs Mason had already reported gambling issues while taking pramipexole. They acknowledged that alternative medication should have been prescribed, and if it had been, the gambling side effects from June 2019 onwards would not have occurred.

Following negotiations, Mrs Mason accepted a £70,000 settlement to compensate for her financial losses and the distress she had endured.

How Switalskis can help you

For Mrs Mason, the compensation was about more than just financial redress. It was a relief to have it confirmed that her medication had caused the gambling addiction—something she had long suspected but had never been warned about. She is now determined to raise awareness so that others do not go through the same experience.

At Switalskis, we have supported many clients affected by negligent treatment for RLS. If you or a loved one have suffered due to medical failings, we are here to help.

We have represented several clients who have suffered due to negligent treatment for RLS, and we welcome efforts to raise awareness of these issues. Earlier this month, the BBC published an article highlighting the devastating impact that dopamine agonists have had on many people’s lives. You can read the full article here .

If you or a loved one have been affected by negligent treatment for RLS, we are here to help. To discuss your experience and explore your legal options, please contact Kimberley Bradfield.

 Call us on 0800 1380 458 or email help@switalskis.com