title: Pramipexole in the treatment of REM sleep behaviour disorder: A critical review.
abstract: While widely accepted as a first-line treatment for rapid eye movement sleep (REM) behaviour disorder, clonazepam (CNZP) has side effects that limit its applicability. Pramipexole is a possible alternative, but limited literature on its effectiveness exists. This review aims to summarize the available data on the use of pramipexole in REM sleep behaviour disorder. A systematic search of major databases was conducted to look for published and on-going trials. This search yielded a total of five articles, all of which are observational in nature. Factors associated with effectiveness include low doses (less than 1.5mg/day) and idiopathic rapid eye movement sleep behaviour disorder/absence of neurodegenerative disease. Overall, the evidence is inconclusive. This is due to the lack of randomised controlled trials and the challenges in interpreting polysomgraphy findings in rapid eye movement sleep behaviour disorder. Suggestions are given on how future trials evaluating pramipexole treatment in rapid eye movement sleep behaviour disorder could overcome current methodological issues in extant literature.
authors.affiliation: Singapore General Hospital, Singapore. Electronic address: tan.shian.ming@singhealth.com.sg.
authors.forename: Shian Ming
authors.initials: SM
authors.lastname: Tan
authors.affiliation: Ng Teng Fong General Hospital, Singapore. Electronic address: Yi_Min_WAN@juronghealth.com.sg.
authors.forename: Yi Min
authors.initials: YM
authors.lastname: Wan
mesh_terms: D052160:Benzothiazoles / Q000494:pharmacology / Q000627:therapeutic use*; D002998:Clonazepam / Q000494:pharmacology / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D064887:Observational Studies as Topic / Q000379:methods; D017286:Polysomnography / Q000187:drug effects; D000077487:Pramipexole; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012895:Sleep, REM / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D052160:Benzothiazoles; D018491:Dopamine Agonists; D002998:Clonazepam; D000077487:Pramipexole
keywords: Dopamine agonists; Sleep disorders; Systematic review