Treatment
Clonazepam is the drug of choice to treat REM Behavior Disorder (RBD).
Clonazepam has shown immense benefits in about 90 % of RBD cases with negligible disadvantages related to tolerance or abuse. The response usually begins within the first week, often on the first night.
Mechanism of action - Clonazepam is a benzodiazepine with anticonvulsant effects that has been shown to block neurotransmission in people with RBD, allowing them to achieve muscular paralysis during REM sleep.
The treatment needs to be continuous, beginning with an initial dose of 0.5 mg at bedtime. The strength may need to be upgraded to 1 mg to witness significant improvement in certain cases.
People with renal complications, pregnant women, and people who are taking other medications may not be good candidates for treatment with clonazepam. Several studies have demonstrated the beneficial effect of melatonin on RBD. Other medications, such as tricyclic antidepressants, may be effective in some persons with RBD.
