Walther B W, Schulz H
Klinikum Erfurt GmbH, Klinik für Neurologie, Erfurt.
Z Arztl Fortbild Qualitatssich. 2001 Jan;95(1):23-6.
Pharmacological therapies are presented for two typical neurological sleep-wake disorders, restless legs syndrome (RLS) and narcolepsy. The individual discomfort caused by RLS and the accompanying problems with initiating and maintaining sleep often require a therapy with L-dopa and dopamine agonists. Positive treatment effects on sensory and motor symptoms have been shown in open trials and controlled studies. Development of time shift and/or augmentation of symptoms is a problem of L-dopa therapy. Further efficient drugs are opioids and benzodiazepines. The therapy of narcolepsy depends on its severity and the pattern of the symptoms. Excessive daytime sleepiness and sleep attacks are the most impairing symptoms, which are difficult to treat. These symptoms require an optimal combination of CNS stimulants with regular napping. Cataplexy and other REM sleep associated symptoms are effectively treated with REM sleep suppressing antidepressants.
本文介绍了针对两种典型的神经睡眠-觉醒障碍——不安腿综合征(RLS)和发作性睡病的药物治疗方法。RLS引起的个体不适以及随之而来的入睡和维持睡眠问题通常需要使用左旋多巴和多巴胺激动剂进行治疗。开放试验和对照研究表明,这些药物对感觉和运动症状有积极的治疗效果。左旋多巴治疗存在时间推移和/或症状加重的问题。其他有效的药物包括阿片类药物和苯二氮䓬类药物。发作性睡病的治疗取决于其严重程度和症状模式。白天过度嗜睡和睡眠发作是最具损害性的症状,且难以治疗。这些症状需要中枢神经系统兴奋剂与定期小睡的最佳组合。猝倒和其他与快速眼动睡眠相关的症状可通过抑制快速眼动睡眠的抗抑郁药有效治疗。