Restless legs syndrome (RLS)/Willis-Ekbom disease (WED) is a common disorder, 
occurring at least twice a week and causing at least moderate distress in 1.5% 
to 2.7% of the population. It is important for primary care physicians to be 
familiar with this disorder and its management. Much has changed in its 
management since our previous algorithm was published in 2004, including the 
availability of several new drugs. This revised algorithm was written by members 
of the Medical Advisory Board of the Willis-Ekbom Disease Syndrome Foundation 
based on scientific evidence and expert opinion. It considers the management of 
RLS/WED under intermittent RLS/WED, chronic persistent RLS/WED, and refractory 
RLS/WED. Nonpharmacological approaches, including mental alerting activities, 
avoiding substances or medications that may exacerbate RLS, and the role of iron 
supplementation, are outlined. Chronic persistent RLS/WED should be treated with 
either a nonergot dopamine agonist or a calcium channel α-2-δ ligand. We discuss 
the available drugs, the factors determining which to use, and their adverse 
effects. We define refractory RLS/WED and describe management approaches, 
including combination therapy and the use of high-potency opioids.