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Treatment outcomes in REM sleep behavior disorder
Stuart J McCarter1, Christopher L Boswell, Erik K St Louis
1Mayo Clinic College of Medicine, Rochester, MN 55905, USA. mccarter.stuart@mayo.edu
Sleep Medicine
|January 29, 2013
Summary
Melatonin and clonazepam effectively reduced REM sleep behavior disorder (RBD) symptoms and injuries. Melatonin showed fewer adverse effects, suggesting it may be a preferable treatment option for RBD patients.
Area of Science:
- Neurology
- Sleep Medicine
- Pharmacology
Background:
- REM sleep behavior disorder (RBD) is characterized by dream enactment behaviors (DEB) that can cause injury.
- Current RBD treatments aim to reduce DEBs and prevent injury, but long-term outcomes require further study.
Purpose of the Study:
- To describe longitudinal treatment outcomes for REM sleep behavior disorder (RBD) using melatonin and clonazepam.
- To evaluate the effectiveness of melatonin and clonazepam in reducing RBD-associated injuries and improving patient-reported outcomes.
Main Methods:
- A survey and medical record review of consecutive RBD patients treated between 2008-2010.
- Analysis of RBD-related injury frequency, severity, Visual Analog Scale (VAS) ratings, medication dosages, and side effects.
- Statistical comparison of outcomes before and after treatment, and between melatonin and clonazepam groups.
Main Results:
- Both melatonin and clonazepam significantly improved RBD VAS ratings.
- Melatonin treatment was associated with a significant reduction in injuries and fewer adverse effects compared to clonazepam.
- Treatment retention and duration were comparable between the melatonin and clonazepam groups.
Conclusions:
- Melatonin and clonazepam appear comparably effective in reducing RBD behaviors and injuries in a naturalistic setting.
- Melatonin may offer a better safety profile with fewer adverse effects than clonazepam for RBD treatment.
- Further prospective clinical trials are needed to establish evidence-based treatment outcomes for RBD.
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