Pharmacological treatments of REM sleep behaviour disorder in synucleinopathies: a systematic review of effectiveness and safety.

Sleep MedJul 31, 2026 (epub)
Clinical ResearchNeurology

Jess J Byun, Vellingiri Raja Badrakalimuthu

✦ AI-curated · Sources linked

In 30 seconds

This systematic review evaluated the effectiveness and safety of pharmacological treatments for REM sleep behaviour disorder (RBD) in synucleinopathies, including Parkinson's disease and related conditions. Eighteen studies were included, revealing that while clonazepam and melatonin are commonly used, their efficacy and safety are inconsistent. Clonazepam raised safety concerns, while melatonin's effectiveness varied across different phenotypes.

Key findings

  • Clonazepam and melatonin are the principal treatments, but evidence for their efficacy is limited and inconsistent.
  • Subjective clinical improvement was reported more frequently than objective vPSG improvement.
  • Clonazepam raised important safety concerns in vulnerable synucleinopathy populations.
  • Evidence for other pharmacological agents remains preliminary.

Why it matters

Understanding the effectiveness and safety of treatments for RBD in synucleinopathies is crucial for clinicians managing these patients, as current evidence is limited and inconsistent, impacting treatment decisions.

Source

PubMed · PMID 42623795

Published in Sleep Med. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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