Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation  Daniel L. Picchietti, Jennifer G. Hensley, Jacquelyn L. Bainbridge, Kathryn A. Lee, Mauro Manconi, James A. McGregor, Robert M. Silver, Claudia Trenkwalder, Arthur S. Walters  Sleep Medicine Reviews  Volume 22, Pages 64-77 (August 2015) DOI: 10.1016/j.smrv.2014.10.009 Copyright © 2014 Terms and Conditions

Fig. 1 Algorithm for the diagnosis and management of RLS/WED during pregnancy and lactation. Dotted arrows: proceed only after assessment of severity, risks, and benefits by provider and patient. *After 1st trimester. †Avoid concurrent use with diphenhydramine or anticonvulsants. §Refractory: an inadequate response to at least one nonpharmacologic intervention and iron (if ferritin <75 mcg/L), tried over an adequate period of time. ‡Very severe, very refractory: a score of >30 on the International RLS Study Group rating scale and failure to respond to at least one nonpharmacologic treatment, iron (if ferritin <75 mcg/L), and one non-opioid pharmacologic treatment. Abbreviations: ER, extended release; IV, intravenous; % saturation, percent iron saturation; RLS, restless legs syndrome; TIBC, total iron binding capacity; WED, Willis-Ekbom disease. Sleep Medicine Reviews 2015 22, 64-77DOI: (10.1016/j.smrv.2014.10.009) Copyright © 2014 Terms and Conditions