Mirtazapine induces REM sleep behavior disorder (RBD) in parkinsonism

Onofrj, Marco; Luciano, A L; Thomas, Astrid; Iacono, Diego; D'Andreamatteo, Giordano

doi:10.1212/01.wnl.0000042084.03066.c0

Cited by 112 publications

(49 citation statements)

References 19 publications

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“…There are a few recent reports on RBD associated with spinocerebellar atrophy type 3 (Machado-Joseph disease). [63][64][65] As noted above, numerous cases of RBD have been reported in conjunction with MSA, 3,22,23,27,[66][67][68][69][70][71][72] PD, 3,11,22,[24][25][26][27][30][31][32][33][34][35]73 and DLB. 1,10,15,41,45,[47][48][49][50][51][52][53]55,59,60,74 Although frequency data on the presence of RSWA and RBD in the neurodegenerative disorders is based on relatively small numbers of patients thus far, the presence of each in MSA has been reported to be 90% to 95% for RSWA and 68% to 90% for RBD, 66,67 and presence of each in PD is approximately 58% for RSWA and 33% for RBD.…”

Section: The Rbd-synucleinopathy Associationmentioning

confidence: 99%

REM Sleep Behavior Disorder in Parkinson’s Disease and Dementia with Lewy Bodies

Boeve

Silber

Ferman

2004

J Geriatr Psychiatry Neurol

206

106

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Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia manifested by vivid, often frightening dreams associated with simple or complex motor behavior during REM sleep. Patients appear to "act out their dreams," in which the exhibited behaviors mirror the content of the dreams. Management of RBD involves counseling about safety measures in the sleep environment; in those at risk for injury, clonazepam and/or melatonin is usually effective. In this article, the authors present a detailed review of the clinical and polysomnographic features, differential diagnosis, diagnostic criteria, management strategies, and pathophysiologic mechanisms of RBD. They then review the literature and their institutional experience of RBD associated with neurodegenerative disease, particularly Parkinson's disease and dementia with Lewy bodies. The evolving data suggests that RBD may have clinical diagnostic and pathophysiologic significance in isolation and when associated with neurodegenerative disease. (J Geriatr Psychiatry Neurol 2004; 17:146-157)

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Section: The Rbd-synucleinopathy Associationmentioning

confidence: 99%

REM Sleep Behavior Disorder in Parkinson’s Disease and Dementia with Lewy Bodies

Boeve

Silber

Ferman

2004

J Geriatr Psychiatry Neurol

206

106

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“…1,2 It has been increasingly reported among psychiatric populations and has a potential association with use of psychotropics, particularly selective serotonin reuptake inhibitor (SSRI), tricyclic, and serotonin and noradrenergic reuptake inhibitor (SNRI) antidepressants. [3][4][5][6][7][8] A previous case report 5 found that cessation of SSRI treatment did not result in complete resolution of clinical RBD symptoms and polysomnographic (PSG) abnormalities. Our recent clinical epidemiologic study 8 found that 3.8% of psychiatric outpatients might have RBD features over the past year.…”

mentioning

confidence: 99%

REM Sleep Behavior Disorder in Psychiatric Populations

Lam¹,

Zhang²,

Tsoh³

et al. 2010

J. Clin. Psychiatry

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To the Editor: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by a loss of REMrelated muscle atonia and abnormal motor activities during REM sleep with consequent sleep-related injuries. 1,2 It has been increasingly reported among psychiatric populations and has a potential association with use of psychotropics, particularly selective serotonin reuptake inhibitor (SSRI), tricyclic, and serotonin and noradrenergic reuptake inhibitor (SNRI) antidepressants. [3][4][5][6][7][8] A previous case report 5 found that cessation of SSRI treatment did not result in complete resolution of clinical RBD symptoms and polysomnographic (PSG) abnormalities. Our recent clinical epidemiologic study 8 found that 3.8% of psychiatric outpatients might have RBD features over the past year. The prevalence is 10 times more common than that of the typical RBD in the elderly general population. 9 In addition, the RBD features could result in sleep-related injuries and violence, with potential medicolegal repercussions. 8,10 In the current study, we conducted a comprehensive evaluation of clinical and PSG features as well as follow-up response to an open intervention of antidepressant regimen modification.Method. Fifteen depressed subjects with concurrent antidepressant treatment and features suggestive of RBD were included in this case series, which spans from December 2006 to March 2009. They were interviewed by experienced psychiatrists and neurologists for a thorough clinical evaluation, which included a semistructured psychiatric interview and physical examination with Hoehn and Yahr staging for parkinsonism. 11 They also underwent videopolysomnographic assessments at baseline and follow-up.Modification of their current antidepressant regimen was suggested to all subjects. Bupropion was offered as the treatment of choice in this open intervention, as it has rarely been associated

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“…He never presented any episodes of RBD before the operation day, nor during the nearly 3-year postoperative period. He was not treated by mirtazapine known to induce RBD in Parkinsonism [8]. As a disorder of the dopaminergic pathway has been suggested to play a role in RBD (see Introduction), one could suspect that the decrease in dopamine treatment, carried out in the pre-operative period in our patient, could be a precipitating factor.…”

Section: Discussionmentioning

confidence: 90%