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For Patients And Caregivers

Current Therapies for Treating RLS (Check all that apply): †Not approved by the FDA for the treatment of RLS Trademarks are the property of their respective owners
Prescription medication:
Ambien® / Ambien CR® (zolpidem tartrate)† Cymbalta® (duloxetine hydrochloride)† Effexor or Effexor XR (venlafaxine HCl)† Klonopin® (clonazepam)† Levodopa® (L-3,4-dihydroxyphenylalanine)† Lexapro®(escitalopram oxalate)† Lunesta® (eszopiclone)† Mirapex® (pramipexole dihydrochloride) Neurontin® (gabapentin)†	Paxil® (Paroxetine HCl)/Paxil CR® / Generic (Paroxetine HCl)† Prozac or Prozac Generic (Fluoxetine HCl)† Requip® (ropinirole HCl) Sonata® (zaleplon)† Wellbutrin® or Wellbutrin XL® (Bupropion hydrochloride)† Vicodin® (acetaminophen and hydrocodone)† Zoloft® (sertraline HCI)† Other Prescription Sleep Aids Other
Over-the-counter medication: Pain Medication Sleep aid Tylenol® (acetaminophen) Muscle relaxant Other
Other: Diet/Stretching/Exercise Not Currently Treating Other

Conditions suffered from in the past or present (Check all that apply):

Depression	Insomnia
Diabetes	Myalgia
High Blood Pressure	ADHD
High Cholesterol

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