Drug treatment of REM sleep behavior disorders in dementia with Lewy bodies.
BACKGROUND
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.


METHODS
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.


RESULTS
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.
Massironi
Gloria
G
Laboratory of Epidemiology and Neuroimaging, IRCCS San Giovanni di Dio-FBF, Brescia, Italy.
Galluzzi
Samantha
S
Frisoni
Giovanni B
GB
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D002998:Clonazepam / Q000009:adverse effects / Q000627:therapeutic use*; D000077265:Donepezil; D004305:Dose-Response Relationship, Drug; D005260:Female; D005917:Globus Pallidus / Q000187:drug effects; D006801:Humans; D007189:Indans / Q000009:adverse effects / Q000627:therapeutic use*; D020961:Lewy Body Disease / Q000188:drug therapy*; D008125:Locus Coeruleus / Q000187:drug effects; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009415:Nerve Net / Q000187:drug effects; D045042:Pedunculopontine Tegmental Nucleus / Q000187:drug effects; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D020187:REM Sleep Behavior Disorder / Q000188:drug therapy*; D012895:Sleep, REM / Q000187:drug effects; D020922:Sleep-Wake Transition Disorders / Q000188:drug therapy; D016896:Treatment Outcome; D014754:Violence / Q000517:prevention & control
D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D001569:Benzodiazepines; D002998:Clonazepam; D000077265:Donepezil