ArticleCureus2026
Tramadol for Refractory Restless Legs Syndrome Following Methadone Intolerance: A Case Report.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Restless legs syndrome (RLS) refractory to guideline-directed therapy may require treatment with low-dose opioids. Methadone is an established option for refractory RLS but may be limited by medication intolerance. We present a 52-year-old woman with refractory RLS who failed multiple pharmacologic therapies, including ropinirole, carbidopa/levodopa, gabapentin, and pregabalin. Methadone produced excellent symptom control but was discontinued because of dysphoria, emotional lability, cognitive slowing, and persistent daytime grogginess. Transition to tramadol 50 mg nightly resulted in sustained symptom control without recurrence of these adverse effects, allowing discontinuation of gabapentin and improved daytime functioning. This case highlights the importance of individualized opioid selection in refractory RLS and suggests that tramadol may be an effective alternative for carefully selected patients with methadone intolerance.
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