Neurology®
The most widely read and highly cited peer-reviewed Neurology journal
Quick Search
Advanced Search
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Turkish Translation
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gagnon, J.-F.
Right arrow Articles by Montplaisir, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gagnon, J.-F.
Right arrow Articles by Montplaisir, J.
Related Collections
Right arrow All Sleep Disorders
Right arrow Circadian rhythm sleep disorders
NEUROLOGY 2006;67:742-747
© 2006 American Academy of Neurology
Views & Reviews

Update on the pharmacology of REM sleep behavior disorder

Jean-François Gagnon, PhD, Ronald B. Postuma, MD and Jacques Montplaisir, MD, PhD, FRCPc

From the Centre d’étude du sommeil et des rythmes biologiques (J.-F.G., R.B.P., J.M.), Hôpital du Sacré-Coeur de Montréal and Centre de recherche (J.-F.G.), Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada.

Address correspondence and reprint requests to Dr. Jacques Montplaisir, Centre d’étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Coeur de Montréal, 5400 Boul. Gouin Ouest, Montréal, Québec, H4J 1C5, Canada; e-mail: jy.montplaisir{at}umontreal.ca

REM sleep behavior disorder (RBD) is characterized by complex behavioral manifestations in response to dream content that may cause sleep disruption or injuries to the patient or the bed partner. In this case, the patients need treatment to control their symptoms. Pharmacologic agents have been reported to have positive and negative impacts on REM sleep muscle atonia and the motor behaviors associated with RBD. Clonazepam is efficacious and well tolerated by the majority of patients afflicted by RBD and should be considered as initial treatment. In patients at risk of falls who have cognitive impairment or who have obstructive sleep apneas, melatonin may be a good alternative to clonazepam. Anticholinesterase inhibitors and dopaminergic agents are not of clear benefit. Monoamine oxidase inhibitors, tricyclic antidepressants, serotonergic synaptic reuptake inhibitors, and noradrenergic antagonists can induce or aggravate RBD symptoms and should be avoided in patients with RBD. When these agents are prescribed to patients with neurodegenerative disorders or narcolepsy who are at risk of developing RBD, systematic follow-up may be warranted to detect the emergence of RBD symptoms.

Supported by an operating grant (J.M.) and a postdoctoral studentship (J.-F.G.) from the Canadian Institutes of Health Research. Dr. Montplaisir holds a Canadian Government Chair on Sleep Disorders.

Disclosure: The authors report no conflicts of interest.

Received January 20, 2006. Accepted in final form May 9, 2006.




This article has been cited by other articles:


Home page
 NeurologyHome page
J. E. Ahlskog
Beating a dead horse: Dopamine and Parkinson disease
Neurology, October 23, 2007; 69(17): 1701 - 1711.
[Abstract] [Full Text] [PDF]