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How Real Is “Restless Legs Syndrome”?

The first time I saw a TV commercial about Restless Legs Syndrome, I was pretty sure it was a spoof. I figured I had stumbled across a prime-time Saturday Night Live special and was seeing a well-done fake ad. It was pretty funny, I thought — Restless Legs Syndrome, ha! Who thinks of this stuff? Of course, it turned out to not be a joke at all, but rather a pharmaceutical ad — for Requip, I think. And then I thought, Now this is what Direct-to-Consumer advertising is made for. You make up a disorder, give it an easygoing name, and voila: drug sales.

Oh, cynical me.

Writing in the New York Times, Nicholas Wade reports that researchers in Germany and Iceland have identified a genetic link to the condition, which “should help scientists understand the biological basis of the disorder.”

Not everyone is yet persuaded. Wade cites a recent report in the journal PLoS Medicine by two Dartmouth researchers, Steven Woloshin and Lisa Schwartz, called “Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick.” These skeptics, Wade writes, “argued that its prevalence had been exaggerated by pharmaceutical companies and uncritical newspaper articles, and that giving people diagnoses and powerful drugs were serious downsides of defining the elusive syndrome too broadly.”

Here is the lead of their report:

Life can be hard. Sometimes you feel sad or distracted or anxious. Or maybe you feel a compelling urge to move your legs. But does that mean you are sick? Does it mean you need medication?

Maybe, maybe not. For some people, symptoms are severe enough to be disabling. But for many others with milder problems, these “symptoms” are just the transient experiences of everyday life. Helping sick people get treatment is a good thing. Convincing healthy people that they are sick is not. Sick people stand to benefit from treatment, but healthy people may only get hurt: they get labeled “sick,” may become anxious about their condition, and, if they are treated, may experience side effects that overwhelm any potential benefit.

When asked to comment on this newest genetic finding, Woloshin stuck to his guns, telling Wade he “wouldn’t change a thing” in his PLoS Medicine article.

Which makes it sound as if Woloshin still pretty much thinks of Restless Legs Syndrome as, well, a joke.