Melatonin is the Best Treatment for REM Sleep Behavior Disorder (RBD)
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- čas přidán 2. 02. 2024
- The over-the-counter supplement melatonin is the first line treatment REM Sleep Behavior Disorder (RBD). @andyberkowskimd of ReLACS Health gives the necessary details of how the supplement works, the research behind it, and why it is a better treatment than clonazepam (Klonopin®).
To learn more about RBD, watch this video:
• What is REM Sleep Beha...
Normally, the body's muscles are nearly paralyzed during REM sleep so that one does not act out dreams. In RBD, there a problem with the switch in the brain to shut off the muscle movement, and one can become un-paralyzed and begin acting out dreams. This can lead to talking, yelling, conversation, fighting, and other behaviors that can be dangerous to a spouse in bed or the individual themself.
Treatment primarily involves safety precautions in the bedroom, including mitigating injury to the spouse or the individual themself (e.g. lowering the bed, padding the ground, moving the nightstand away from the bed, sleeping in a separate bed from the bedpartner, etc.). Some individuals can be taken off medication such as antidepressants that are serotonin reuptake inhibitors, which may decrease the behaviors. When these measures have not been enough, and a person with RBD is a threat to themself or disruptive to their spouse or bedpartner, then medication may be warranted.
Melatonin is the first-line drug treatment with clonazepam and other strong prescription drugs can be used.
This video breaks down why clonazepam is a double-edged sword for RBD and sets the stage for melatonin as a preferred option:
• Clonazepam: The Double...
In this video, @andyberkowskimd discusses the following topics:
- What is RBD?
- Review of safety precautions
- Changes that can be made prior to prescribing medications
- Concerns of using clonazepam up front
- How does melatonin work? Do we know?
- A couple studies showing the effectiveness of melatonin for the treatment of RBD
- Dosing of melatonin
- Possible adverse effects
- The concerns about OTC melatonin and the importance of pharmaceutical-grade brands of melatonin for best quality
To read more in depth about sleep and sleep conditions, read A ReLACSing blog:
www.relacshealth.com/blog
This is the small double-blinded, placebo-controlled crossover study of melatonin in RBD:
onlinelibrary.wiley.com/doi/1...
This is the study that compared clonazepam and melatonin:
www.ncbi.nlm.nih.gov/pmc/arti...
This study assessed the (poor) quality of melatonin in over-the-counter brands:
www.ncbi.nlm.nih.gov/pmc/arti...
These videos are for general medical information only, but for those who live in or near Michigan, Ohio, or Florida, you can hire @andyberkowskimd of ReLACS Health for consultation regarding RBD, clonazepam, melatonin, or any other aspect of sleep health that requires more personalization, time, and expertise. Go to www.relacshealth.com/ to schedule your consultation now.
Thanks for this Dr. Berkowski. I'm 58 years old and have a feeling I might have this. I have a meeting with a neurologist on May 24. My question, if you see this, is if I did have RBD and treated it with melatonin, that doesn't mean its been 'cured', correct? I'm still at higher risk of developing a parkinsonian disorder even if the drug helps the symptoms. Its not curing the underlying pathology, am I right?
My husband age 68 has suffered w this over 20 yrs. He’s sleeping on the couch for 10 years. I’m currently taking him off of Zoloft and he’s no longer sitting up and reaching. He’s on our kitty cam. I watch every night. Melatonin did nothing but I only used it for a few weeks. 5mg reg and sustained release. I’m wondering if I get him off the Zoloft totally. He’s down from 150mg to 50mg.
I feel it started w hand movements when he started Zoloft in 2006. I’m just fearful in that I don’t want him getting hurt or kicking the cats.. I’m been sleeping alone very long time.
Tried Vit D also since 2018 from sleep research I found back then. Any one w suggestions is appreciated!
Kicking n screaming from NJ
SSRI medications that are used for depression are one of the main causes of RBD. This is not to say that it is common to have RBD from these antidepressants, but that among the causes of RBD after it is diagnosed, adjustment to antidepressant medications is one of the approaches used to improve symptoms.
Dr B , Is it true that high doses of melatonin can interfere with natural balance in the brain and create different problems, like with adrenals for example.
You mentioned Clonazepam, what about lorazepam, assume it’s similar situation, is it possible to transition from these medications to melatonin instead or once someone used benzo for sleep problems it’s not possible to switch. Withdrawals issues may be a problem, or interactions?
Docs sometimes recommend ramelteon for sleep problems which works on melatonin receptors, what’s your opinion on it Dr B . Thank you
I'm not sure if lorazepam (Ativan) has been studied but I have prescribed it for RBD, albeit rarely, to avoid the side effects from clonazepam as it is a shorter acting drug. Sleep experts think there is a class effect in which many benzodiazepines could work though clonazepam is the most common. Ramelteon is a melatonin receptor stimulator and may also work for RBD (and I have rarely used it as well), and because it is a brand name drug, maybe there will be more studies in RBD in the future (unlike with the generic lorazepam).
What brand of Melatonin have you found to be best and most accurate with their dosage?
Pure encapsulations tends to have exclusively pharmacy-grade products. Natrol has a good reputation and has been used in research trials with melatonin. There are others that have certifications and quality testing but be wary of most.
@@andyberkowskimd So USP is a good certification for this?