Best Practice Guide for the Treatment of REM Sleep Behavior Disorder (RBD)
R. Nisha Aurora,Rochelle S. Zak,Rama Maganti,Sanford Auerbach,Kenneth R. Casey,Susmita Chowdhuri,Anoop Karippot,Kannan Ramar,David A. Kristo,Timothy I. Morgenthaler +9 more
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TLDR
Modifying the sleep environment is recommended for the treatment of patients with RBD who have sleep-related injury and the use of Clonazepam should be used with caution in patients with dementia, gait disorders, or concomitant OSA.Abstract:
Summary of Recommendations:
Modifying the sleep environment is recommended for the treatment of patients with RBD who have sleep-related injury. Level A
Clonazepam is suggested for the treatment of RBD but should be used with caution in patients with dementia, gait disorders, or concomitant OSA. Its use should be monitored carefully over time as RBD appears to be a precursor to neurodegenerative disorders with dementia in some patients. Level B
Clonazepam is suggested to decrease the occurrence of sleep-related injury caused by RBD in patients for whom pharmacologic therapy is deemed necessary. It should be used in caution in patients with dementia, gait disorders, or concomitant OSA, and its use should be monitored carefully over time. Level B
Melatonin is suggested for the treatment of RBD with the advantage that there are few side effects. Level B
Pramipexole may be considered to treat RBD, but efficacy studies have shown contradictory results. There is little evidence to support the use of paroxetine or L-DOPA to treat RBD, and some studies have suggested that these drugs may actually induce or exacerbate RBD. There are limited data regarding the efficacy of acetylcholinesterase inhibitors, but they may be considered to treat RBD in patients with a concomitant synucleinopathy. Level C
The following medications may be considered for treatment of RBD, but evidence is very limited with only a few subjects having been studied for each medication: zopiclone, benzodiazepines other than clonazepam, Yi-Gan San, desipramine, clozapine, carbamazepine, and sodium oxybate. Level Cread more
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Journal ArticleDOI
Diagnosis and management of dementia with Lewy bodies Fourth consensus report of the DLB Consortium
Ian G. McKeith,Bradley F. Boeve,Dennis W. Dickson,Glenda M. Halliday,John-Paul Taylor,Daniel Weintraub,Dag Aarsland,Dag Aarsland,James E. Galvin,Johannes Attems,Johannes Attems,Clive Ballard,Clive Ballard,Ashley Bayston,Ashley Bayston,Thomas G. Beach,Thomas G. Beach,Frédéric Blanc,Nicolaas Bohnen,Nicolaas Bohnen,Nicolaas Bohnen,Laura Bonanni,Laura Bonanni,Jose Bras,Jose Bras,Patrik Brundin,Patrik Brundin,David J. Burn,David J. Burn,Alice Chen-Plotkin,John E. Duda,Omar M. A. El-Agnaf,Howard Feldman,Tanis J. Ferman,Dominic Ffytche,Hiroshige Fujishiro,Douglas Galasko,Jennifer G. Goldman,Stephen N. Gomperts,Neill R. Graff-Radford,Lawrence S. Honig,Lawrence S. Honig,Alex Iranzo,Alex Iranzo,Alex Iranzo,Kejal Kantarci,Daniel I. Kaufer,Walter Kukull,Virginia M.Y. Lee,James B. Leverenz,James B. Leverenz,Simon J.G. Lewis,Carol F. Lippa,Carol F. Lippa,Angela Lunde,M Masellis,M Masellis,M Masellis,Eliezer Masliah,Pamela J. McLean,Brit Mollenhauer,Brit Mollenhauer,Thomas J. Montine,Thomas J. Montine,Emilio Moreno,Emilio Moreno,Emilio Moreno,Etsuro Mori,Etsuro Mori,Etsuro Mori,Melissa E. Murray,John T. O'Brien,John T. O'Brien,Sotoshi Orimo,Sotoshi Orimo,Ronald B. Postuma,Ronald B. Postuma,Shankar Ramaswamy,Shankar Ramaswamy,Owen A. Ross,David P. Salmon,David P. Salmon,Andrew B. Singleton,Andrew B. Singleton,Angela Taylor,Angela Taylor,Alan Thomas,Pietro Tiraboschi,Jon B. Toledo,John Q. Trojanowski,Debby W. Tsuang,Zuzana Walker,Zuzana Walker,Masahito Yamada,Masahito Yamada,Kenji Kosaka +95 more
TL;DR: The Dementia with Lewy Bodies (DLB) Consortium has refined its recommendations about the clinical and pathologic diagnosis of DLB, updating the previous report, which has been in widespread use for the last decade.
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Pharmacological Treatment of Parkinson Disease: A Review
TL;DR: Strong evidence supports using levodopa and dopamine agonists for motor symptoms at all stages of Parkinson disease, and other therapies for motor and nonmotor features is less well established.
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British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders.
Sue Wilson,David J. Nutt,Chris Alford,S. V. Argyropoulos,David S. Baldwin,A. N. Bateson,Thomas Bennett Britton,C. Crowe,D-J Dijk,Colin A. Espie,Paul Gringras,Göran Hajak,C. Idzikowski,Andrew D. Krystal,J. R. Nash,H. Selsick,Ann L. Sharpley,A. G. Wade +17 more
TL;DR: These British Association for Psychopharmacology guidelines are designed to address this problem by providing an accessible up-to-date and evidence-based outline of the major issues, especially those relating to reliable diagnosis and appropriate treatment.
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Melatonin antioxidative defense: therapeutical implications for aging and neurodegenerative processes.
Seithikurippu R. Pandi-Perumal,Seithikurippu R. Pandi-Perumal,Ahmed S. BaHammam,Gregory M. Brown,Gregory M. Brown,D. Warren Spence,Vijay K. Bharti,Charanjit Kaur,Rüdiger Hardeland,Daniel P. Cardinali +9 more
TL;DR: Melatonin’s efficacy in combating free radical damage in the brain suggests that it can be a valuable therapeutic agent in the treatment of cerebral edema following traumatic brain injury or stroke.
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Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders
TL;DR: The most convincing evidence for exogenous melatonin use was in reducing sleep onset latency in primary insomnia, delayed sleep phase syndrome, and regulating the sleep-wake patterns in blind patients compared with placebo, which highlights the potential importance of melatonin in treating certain first degree sleep disorders.
References
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Book
Principles and Practice of Sleep Medicine
TL;DR: Part 1: Normal Sleep and Its Variations; Part 2: Abnormal Sleep.
Journal ArticleDOI
Diagnosis and management of dementia with Lewy bodies: Third report of the DLB Consortium
Ian G. McKeith,Ian G. McKeith,Dennis W. Dickson,James Lowe,Murat Emre,John T. O'Brien,Howard Feldman,Jeffrey L. Cummings,John E. Duda,Carol F. Lippa,Elaine K. Perry,Dag Aarsland,Hiroyuki Arai,Clive Ballard,B. F. Boeve,David J. Burn,Durval C. Costa,T. Del Ser,Bruno Dubois,Douglas Galasko,Serge Gauthier,Christopher G. Goetz,Estrella Gómez-Tortosa,Glenda M. Halliday,L. A. Hansen,John Hardy,Takeshi Iwatsubo,Raj N. Kalaria,Daniel I. Kaufer,Rose Anne Kenny,Amos D. Korczyn,Kenji Kosaka,Virginia M.-Y. Lee,Andrew J. Lees,Irene Litvan,Elisabet Londos,Oscar L. Lopez,Satoshi Minoshima,Yoshikuni Mizuno,José Antonio Molina,Elizabeta B. Mukaetova-Ladinska,Florence Pasquier,Robert H. Perry,Jörg B. Schulz,John Q. Trojanowski,Masahito Yamada +45 more
TL;DR: The dementia with Lewy bodies (DLB) Consortium has revised criteria for the clinical and pathologic diagnosis of DLB incorporating new information about the core clinical features and suggesting improved methods to assess them as mentioned in this paper.
The RAND/UCLA Appropriateness Method User's Manual
TL;DR: The "RAND/UCLA Appropriateness Method" was developed by RAND and UCLA in the 198Os and has been further developed and refined in North America and, increasingly, in Europe.
Journal ArticleDOI
Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder
TL;DR: RBD can be the heralding manifestation of Parkinson's disease in a substantial subgroup of older male RBD patients, and the pedunculopontine nucleus is implicate as a likely site of pathology in combined RBD-Parkinson's disease, based on experimental and theoretical considerations rather than on autopsy data.
Journal ArticleDOI
Chronic behavioral disorders of human REM sleep: a new category of parasomnia.
TL;DR: These REM sleep neurobehavioral disorders constitute another category of parasomnia, replicate findings from 21 years ago in cats receiving pontine tegmental lesions, and offer additional perspectives on human behavior, neurophysiology, pharmacology, and dream phenomenology.
Related Papers (5)
Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases.
Chronic behavioral disorders of human REM sleep: a new category of parasomnia.
Pathophysiology of REM sleep behaviour disorder and relevance to neurodegenerative disease
B. F. Boeve,M. H. Silber,Clifford B. Saper,Tanis J. Ferman,Dennis W. Dickson,Joseph E. Parisi,Eduardo E. Benarroch,J. E. Ahlskog,Glenn E. Smith,R. C. Caselli,M. Tippman-Peikert,E. J. Olson,Siong-Chi Lin,T. Young,Z. Wszolek,C. H. Schenck,M. W. Mahowald,Pablo R. Castillo,K. Del Tredici,Heiko Braak +19 more