Jiménez-Jiménez Félix Javier, Alonso-Navarro Hortensia, García-Martín Elena, Agúndez José A G
Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, E-28500 Madrid, Spain.
University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, ARADyAL Instituto de Salud Carlos III, E-10071 Cáceres, Spain.
J Pers Med. 2021 Nov 14;11(11):1204. doi: 10.3390/jpm11111204.
The symptomatic treatment of REM sleep behaviour disorder (RBD) is very important to prevent sleep-related falls and/or injuries. Though clonazepam and melatonin are usually considered the first-line symptomatic therapy for RBD, their efficiency has not been proven by randomized clinical trials. The role of dopamine agonists in improving RBD symptoms is controversial, and rivastigmine, memantine, 5-hydroxytryptophan, and the herbal medicine yokukansan have shown some degree of efficacy in short- and medium-term randomized clinical trials involving a low number of patients. The development of potential preventive therapies against the phenoconversion of isolated RBD to synucleinopathies should be another important aim of RBD therapy. The design of long-term, multicentre, randomized, placebo-controlled clinical trials involving a large number of patients diagnosed with isolated RBD with polysomnographic confirmation, directed towards both symptomatic and preventive therapy for RBD, is warranted.
快速眼动睡眠行为障碍（RBD）的对症治疗对于预防与睡眠相关的跌倒和/或损伤非常重要。尽管氯硝西泮和褪黑素通常被认为是RBD的一线对症治疗药物，但其疗效尚未通过随机临床试验得到证实。多巴胺激动剂在改善RBD症状方面的作用存在争议，在涉及患者数量较少的短期和中期随机临床试验中， rivastigmine、美金刚、5-羟色氨酸和草药逍遥散已显示出一定程度的疗效。针对将孤立性RBD转化为突触核蛋白病进行潜在预防性治疗也应是RBD治疗的另一个重要目标。开展长期、多中心、随机、安慰剂对照的临床试验是必要的，该试验需纳入大量经多导睡眠图证实的孤立性RBD患者，旨在针对RBD进行对症和预防性治疗。
