Safety and efficacy of melatonin, clonazepam, and trazodone in patients with Parkinson’s disease and sleep disorders: a randomized, double-blind trial

Hadi, Fatemeh; Agah, Elmira; Tavanbakhsh, Samaneh; Mirsepassi, Zahra; Mousavi, Seyed Vahid; Talachi, Negin; Tafakhori, Abbas; Meshkat, Shakila

doi:10.1007/s10072-022-06188-4

Cited by 17 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The evidence for these insomnia medications is limited by lack of high-quality studies [32], and there have not been any RCTs comparing various insomnia medications until recently. In a recent study randomizing 93 subjects with PD to melatonin 3 mg, clonazepam 1 mg, and trazodone 50 mg were all found to similarly improve sleep quality as measured by the Pittsburgh Sleep Quality Index [33]. Though clonazepam and melatonin are currently the two main treatments commonly used for RBD, this study found a greater reduction in RBD Screening Questionnaire for melatonin compared to clonazepam with a better side effect profile.…”

Section: Advances In Pharmacological Interventions For Non-motor Symp...mentioning

confidence: 59%

Parkinson's disease – current treatment

Wang

Shih

2023

Current Opinion in Neurology

View full text Add to dashboard Cite

Purpose of Review The purpose is to review the results and impact of recent studies for current and future treatment of both motor and non-motor symptoms in Parkinson's disease (PD). Recent Findings New formulations of levodopa further optimize motor fluctuations, allowing for more on-time and less dyskinesia. On demand apomorphine continues to showcase itself as an effective and tolerable tool for treating motor off-periods. Though there are no clear treatment guidelines for PD-related constipation and sleep related disorders, several new agents for these non-motor symptoms show promising preliminary data. Expiratory muscle strength training may represent a useful and cost-effective strategy to alleviate oropharyngeal dysphagia associated with PD. There is evidence to suggest that the use of shorter pulse width and directional deep brain stimulation leads can results in a greater therapeutic window. Summary Though no interventions currently exist to significantly modify the disease progression of PD, new studies continue to give insight into optimal symptomatic management. Clinicians should be familiar with expanding the repertoire of tools available to treat the diverse range of symptoms and challenges associated with PD.

show abstract

Section: Advances In Pharmacological Interventions For Non-motor Symp...mentioning

confidence: 59%

Parkinson's disease – current treatment

Wang

Shih

2023

Current Opinion in Neurology

View full text Add to dashboard Cite

show abstract

“…This molecule acts as an antagonist of the serotonin 5HT2a/c receptor, the stimulation of which has a known antidopaminergic effect. In relation to this function, trazodone improved depressive symptoms and motor function in patients with Parkinson’s disease [ 76 ]. In patients with Parkinson’s, there are few data concerning the use of trazodone as a hypnotic inducer.…”

Section: Available Drugs and State Of Art Of Treatmentmentioning

confidence: 99%

Clinical Evaluation of Sleep Disorders in Parkinson’s Disease

et al. 2023

View full text Add to dashboard Cite

The paradigm of the framing of Parkinson’s disease (PD) has undergone significant revision in recent years, making this neurodegenerative disease a multi-behavioral disorder rather than a purely motor disease. PD affects not only the “classic” substantia nigra at the subthalamic nuclei level but also the nerve nuclei, which are responsible for sleep regulation. Sleep disturbances are the clinical manifestations of Parkinson’s disease that most negatively affect the quality of life of patients and their caregivers. First-choice treatments for Parkinson’s disease determine amazing effects on improving motor functions. However, it is still little known whether they can affect the quantity and quality of sleep in these patients. In this perspective article, we will analyze the treatments available for this specific clinical setting, hypothesizing a therapeutic approach in relation to neurodegenerative disease state.

show abstract

“…High‐quality evidence for the pharmacotherapy of RBD is limited (Table S1.2). Clinical observations of effectiveness have led to melatonin and clonazepam being considered first‐line treatments for RBD; however, RCTs for these treatments are few and do not demonstrate superiority of melatonin, nor clonazepam, over placebo 102–107 . They also have methodological limitations, including small sample sizes and potentially unreliable outcome measures 9,108 .…”

Section: Rem Sleep Behavior Disordermentioning

confidence: 99%

“…Clinical observations of effectiveness have led to melatonin and clonazepam being considered first-line treatments for RBD; however, RCTs for these treatments are few and do not demonstrate superiority of melatonin, nor clonazepam, over placebo. [102][103][104][105][106][107] They also have methodological limitations, including small sample sizes and potentially unreliable outcome measures. the other hand, is well tolerated at doses between 3 and 12 mg and despite less evidence for efficacy, represents a safer option for first-line treatment.…”

Section: Management Of Rbd In Lbdmentioning

confidence: 99%

Sleep disorders in Lewy body dementia: Mechanisms, clinical relevance, and unanswered questions

Townsend

Anderson

Boeve

et al. 2023

Alzheimer's & Dementia

View full text Add to dashboard Cite

In Lewy body dementia (LBD), disturbances of sleep and/or arousal including insomnia, excessive daytime sleepiness, rapid eye movement (REM) sleep behavior disorder, obstructive sleep apnea, and restless leg syndrome are common. These disorders can each exert a significant negative impact on both patient and caregiver quality of life; however, their etiology is poorly understood. Little guidance is available for assessing and managing sleep disorders in LBD, and they remain under‐diagnosed and under‐treated. This review aims to (1) describe the specific sleep disorders which occur in LBD, considering their putative or potential mechanisms; (2) describe the history and diagnostic process for these disorders in LBD; and (3) summarize current evidence for their management in LBD and consider some of the ongoing and unanswered questions in this field and future research directions.

show abstract

Safety and efficacy of melatonin, clonazepam, and trazodone in patients with Parkinson’s disease and sleep disorders: a randomized, double-blind trial

Cited by 17 publications

References 22 publications

Parkinson's disease – current treatment

Parkinson's disease – current treatment

Clinical Evaluation of Sleep Disorders in Parkinson’s Disease

Sleep disorders in Lewy body dementia: Mechanisms, clinical relevance, and unanswered questions

Contact Info

Product

Resources

About