BACKGROUND: Since the publication of the first European Federation of 
Neurological Societies (EFNS) guidelines in 2005 on the management of restless 
legs syndrome (RLS; also known as Willis-Ekbom disease), there have been major 
therapeutic advances in the field. Furthermore, the management of RLS is now a 
part of routine neurological practice in Europe. New drugs have also become 
available, and further randomized controlled trials have been undertaken. These 
guidelines were undertaken by the EFNS in collaboration with the European 
Neurological Society and the European Sleep Research Society.
OBJECTIVES: To provide an evidence-based update of new treatments published 
since 2005 for the management of RLS.
METHODS: First, we determined what the objectives of management of primary and 
secondary RLS should be. We developed the search strategy and conducted a review 
of the scientific literature up to 31 December 2011 (print and electronic 
publications) for the drug classes and interventions employed in RLS treatment. 
Previous guidelines were consulted. All trials were analysed according to class 
of evidence, and recommendations made according to the 2004 EFNS criteria for 
rating.
RECOMMENDATIONS: Level A recommendations can be made for rotigotine, ropinirole, 
pramipexole, gabapentin enacarbil, gabapentin and pregabalin, which are all 
considered effective for the short-term treatment for RLS. However, for the 
long-term treatment for RLS, rotigotine is considered effective, gabapentin 
enacarbil is probably effective, and ropinirole, pramipexole and gabapentin are 
considered possibly effective. Cabergoline has according to our criteria a level 
A recommendation, but the taskforce cannot recommend this drug because of its 
serious adverse events.