Restless legs syndrome (RLS) is a common neurological condition that causes an overwhelming urge to move the legs, often accompanied by involuntary jerking of the limbs. For many people, the symptoms can be unbearable, severely disrupting daily life and making it difficult to get a good night’s sleep.

In a recent report shared by the BBC , twenty women told how they were prescribed drugs for RLS, known as dopamine agonist drugs. The drug is warned to increase libido and harmful behaviour, however there is no explicit reference to this in the patient leaflet.

A report by drugs firm GSK found that the medicine could cause ‘deviant’ sexual behaviour, alter sexual interests, and draw users to risky sexual behaviour. Others have described feeling compelled to gamble or overspend.

With RLS thought to affect up to 10% of the UK population, it is essential that those experiencing symptoms receive the right treatment. However, in our work, we have seen many cases where the treatment of RLS has fallen short—sometimes with devastating consequences.

Below, we highlight some of the key failures we have encountered when supporting our clients.

1. Failing to measure serum ferritin levels

One of the most common failures we see is the failure to measure serum ferritin levels before prescribing medication. NHS Clinical Knowledge Summaries (CKS) guidance is clear that all patients with RLS should have their serum ferritin levels checked via a simple blood test. This is because low ferritin levels can be a cause of RLS, and in some cases, iron supplements alone may alleviate or even resolve symptoms—removing the need for prescription medication altogether. Despite this, we continue to see cases where this critical step is missed.

2. Lack of warnings about dopamine agonist side effects

When medication is needed, dopamine agonists such as pramipexole or ropinirole are often prescribed. However, these drugs can have severe side effects, including impulse control disorders that may lead to compulsive gambling, excessive eating, reckless spending, or hypersexuality. These behaviours can be life-altering—leading to financial ruin, relationship breakdowns, and job loss. Tragically, many patients are not warned about these risks, leaving them unaware of the cause when these behaviours emerge. Many suffer in silence, too ashamed to seek help.

3. Swapping one dopamine agonist for another

If a patient experiences side effects from one dopamine agonist, switching to another (such as swapping pramipexole for ropinirole) is unlikely to resolve the problem. These medications work in the same way and carry the same risks. Instead, alternative treatments, such as gabapentin or pregabalin, may be more suitable and have fewer debilitating side effects. We have seen too many cases where patients have been left to struggle unnecessarily because this important distinction was not recognised.

4. Failing to identify augmentation

A concerning issue with dopamine agonist treatment is "augmentation"—where symptoms worsen rather than improve. This can mean symptoms start earlier in the day or spread to other areas of the body, such as the arms. Over time, dopamine agonist medications can overstimulate the brain, causing changes that lead to increased dependency. Instead of recognising this pattern, some doctors simply increase the dose—worsening the condition rather than alleviating it. CKS guidelines provide clear recommendations for managing augmentation, but we have seen many cases where these are not followed.

Contact Switalskis clinical negligence specialists

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 week, 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