Rasagiline for sleep disorders in patients with Parkinson’s disease: a prospective observational study

Abstract

IntroductionRasagiline is a selective, irreversible monoamine oxidase B inhibitor that ameliorates the symptoms of Parkinson’s disease (PD) by inhibiting striatal dopamine metabolism. There is also evidence that monoamine oxidase B inhibitors increase melatonin levels in the pineal gland and may have a beneficial effect on sleep disorders, which are a common feature in patients with PD.MethodsThis single-center, prospective, observational, 12-week study compared the effect of combination therapy with levodopa 200–300 mg/d + rasagiline 1 mg/d (n=19) with levodopa 200–300 mg/d alone (n=19) in the treatment of sleep disorders in patients with idiopathic PD.ResultsAfter 12 weeks’ treatment, mean sleep latency was significantly (P<0.001) lower and the improvement in sleep latency from baseline was significantly (P=0.001) greater in patients receiving levodopa + rasagiline than in patients receiving levodopa alone. Similarly, at the end of the study, the mean total sleep time was significantly (P=0.002) longer and the improvement from baseline in mean total sleep time was significantly (P=0.026) greater in patients receiving levodopa + rasagiline than levodopa alone. There were no significant differences between treatment groups for the mean number of awakenings reported at week 12 nor the change from baseline to week 12 in mean number of awakenings.ConclusionAdding rasagiline to levodopa improved sleep outcomes and may be an appropriate option for patients with PD experiencing sleep disorders.

The Treatment of Sleep Disorders in Parkinson’s Disease: From Research to Clinical Practice

“…A single-center, prospective, observational study compared 19 PD patients treated with LD 200–300 mg/day associated with rasagiline 1 mg/day with 19 PD patients treated only with LD 200–300 mg/day. After 12 weeks of treatment, the group treated with LD and rasagiline showed a significant reduction in mean sleep latency and an increase in mean total sleep time ( 28 ).…”

Management Recommendations on Sleep Disturbance of Patients with Parkinson's Disease

“…A single-center prospective observational study found that compared to monotherapy with LD, the combination of rasagiline and LD significantly decreased the sleep latency and elongated sleep time of PD patients[33] (quality score, 61%). A double-blind, baseline-controlled study found that rasagiline may be beneficial to the sleep quality of PD patients with sleep disturbance.…”

Efficacy of cognitive behavioral therapy for insomnia comorbid to Parkinson's disease: A focus on psychological and daytime functioning with a single‐case design with multiple baselines

“…Interventional studies have provided insufficient evidence to suggest that pharmacotherapy improves insomnia associated with PD. In this context, nonbenzodiazepine hypnotic, sedative atypical antipsychotic, anti‐depressive, dopaminergic agents, and melatonin have been tested (Calandra‐Buonaura et al, ; Dowling et al, ; Juri, Chaná, Tapia, Kunstmann, & Parrao, ; Kashihara et al, ; Medeiros et al, ; Melone et al, ; Menza et al, ; Pierantozzi et al, ; Poewe et al, ; Ray Chaudhuri et al, ; Rios Romenets et al, ). Despite this insufficient therapeutic evidence, sedative agents are still and frequently prescribed to manage sleep complaint in patients with PD (Lin et al, ).…”