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In this interview, Diego Garcia-Borreguero, MD, PhD, Sleep Research Institute, Madrid, Spain, provides a comprehensive overview of the treatment of restless legs syndrome (RLS), including the consequences of long-term treatment with dopamine agonists. Notably, previous treatment with dopaminergic agents for more than 5 years may lead to poorer responses to subsequent alternative therapies. Therapies that upregulate extracellular adenosine, such as dipyridamole, or inhibit glutamatergic function, such as perampanel, may provide a suitable alternative to dopamine agonists, however these are currently not formally approved for use in RLS. This interview took place at the Sleep Europe 2024 congress in Seville, Spain. These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.