Drug Treatment of REM Sleep Behavior Disorders in Dementia With Lewy Bodies

Laboratory of Epidemiology and Neuroimaging, IRCCS San Giovanni di Dio-FBF, Brescia, Italy.
International Psychogeriatrics (Impact Factor: 1.93). 01/2004; 15(4):377-83. DOI: 10.1017/S1041610203009621
Source: PubMed


Dementia with Lewy bodies (DLB) is often associated with REM sleep behavior disorders (RBD) characterized, in contrast to the usual paralysis of REM sleep, by violent motor and verbal activity.
The pharmacological management of RBD was investigated in three DLB patients treated with clonazepam, a benzodiazepine used as an antiepileptic, or donepezil, a cholinesterase inhibitor.
All three patients had marked improvement. The pharmacodynamic mechanisms underlying the efficacy of the two drugs might be due to facilitator effect on the pedunculopontine nucleus, a key structure in the physiology of REM sleep.

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    • "ng them , although it should be used with caution in patients with dementia , disorders of gait or balance , or concomitant OSAS . Smaller beneficial effects have been reported for melatonin 3 – 12 mg ( Gagnon et al . , 2006 ) . Single case studies and small series have reported beneficial effects of clonidine ( Nash et al . , 2003 ) , donepezil ( Massironi et al . , 2003 ) and sodium oxybate ( Kosky et al . , 2008 ) . Drugs which can worsen RBD or provoke its symptoms include SSRIs , venlafaxine , mirtazapine , bisoprolol , and tra - madol ( Gagnon et al . , 2006 ) ."
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