Rivastigmine as alternative treatment for refractory REM behavior disorder in Parkinson's disease

Abstract Background: We report on a double‐blind, crossover pilot trial for the treatment of rapid eye movement behavior disorder (RBD) in 12 patients with Parkinson's disease in whom conventional therapy failed. Methods: We employed a patch of the cholinesterase inhibitor rivastigmine at a dose of 4.6 mg/24 hours for 3 weeks compared with placebo to reduce the frequency of RBD episodes. The number of RBD episodes was monitored by diaries of bed partners. Results: Rivastigmine was well tolerated in most patients, with minor side effects, mainly related to peripheral cholinergic action, and significantly reduced the mean frequency of RBD episodes during the observation time. Conclusions: The results of this pilot trial need to be confirmed by further studies on a larger number of patients. © 2012 Movement Disorder Society