Opposite effects of SSRIs and tandospirone in the treatment of REM sleep behavior disorder.
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia defined by intermittent loss of electromyographic atonia during REM sleep with emergence of complex and vigorous behaviors. Although the efficacy of several agents for treating RBD has been reported, a rationale for medication has not been established and the exact pathophysiological mechanisms of RBD are uncertain. We encountered a patient with idiopathic RBD that dramatically improved with selective serotonin reuptake inhibitors (SSRIs) and deteriorated with a 5-HT1A partial agonist, tandospirone. We report on the effects of these serotonin-modulating agents, which yield clues to a possible pharmacological approach to RBD.
Takahashi
Tetsuya
T
Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan. takahash@fmsrsa.fukui-med.ac.jp
Mitsuya
Hironori
H
Murata
Tetsuhito
T
Murayama
Junichi
J
Wada
Yuji
Y
D000368:Aged; D005260:Female; D016666:Fluvoxamine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D054833:Isoindoles / Q000009:adverse effects* / Q000627:therapeutic use; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use*; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D017286:Polysomnography; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D020187:REM Sleep Behavior Disorder / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D011930:Reaction Time / Q000187:drug effects; D017366:Serotonin Receptor Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012895:Sleep, REM / Q000187:drug effects; D016896:Treatment Outcome
D016666:Fluvoxamine; D054833:Isoindoles; D017374:Paroxetine; D010879:Piperazines; D011743:Pyrimidines; D017366:Serotonin Receptor Agonists; D017367:Selective Serotonin Reuptake Inhibitors; C055267:tandospirone