Augmentation refers to a worsening of the symptoms that occurs very commonly among RLS patients after long-term treatment with some certain medications. An overall augmentation rate of 5.6% was reported (Liu et al., 2016). All the current dopaminergic drugs and another non-dopaminergic drug tramadol have been reported to show some degree of augmentation (Trenkwalder et al., 2007; Vetrugno et al., 2007; Hogl et al., 2010; Oertel et al., 2011), which are thought to be related to dose and duration of medication and individual factors such as iron deficiency (Garcia-Borreguero et al., 2013). The highest incidence rate of augmentation occurred with levodopa was up to 60–80% in RLS patients (Hogl et al., 2010). In addition, incidence rate was reported to be higher in patients treating with shorter-acting dopaminergic agents (pramipexole, ropinirole) than longer-acting dopaminergic agents (rotigotine, cabergoling). A possible explanation is the masking of earlier symptom onset by longer-acting dopaminergic agents (Garcia-Borreguero and Williams, 2014). To prevent augmentation, it is important to initiate the treatment with α2δ agonists for milder RLS patients (Silber et al., 2013), and a lowest effective dose of dopaminergic agents should be established to decrease the incidence and delay the occurrence of augmentation (Silber et al., 2013). Management of augmentation is not to increase the dose of dopaminergic agents, but to add a non-dopaminergic agent as a combination strategy (Silber et al., 2013). Moreover, loss of efficacy is the reduction of drug efficacy over time. In these cases, RLS symptoms are not worse than before initiating the treatment (Garcia-Borreguero and Williams, 2014), a combination therapy is recommended in loss of efficacy to decrease the side effects of certain medications, as well as to prevent augmentation.