Abstract
Shortly after initiation of mirtazapine (a noradrenergic and serotonergic antidepressant) treatment in four patients with parkinsonism, the authors observed the appearance of REM sleep behavior disorder (RBD). In the two patients with severe motor symptoms, RBD was accompanied by hallucinations and confusion. These disturbances resolved with drug discontinuation, and remained resolved by 12- to 24-month follow-up, suggesting that RBD can be triggered by a drug lacking anticholinergic activity.
MeSH terms
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Aged
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Antidepressive Agents, Tricyclic / adverse effects*
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Depression / complications
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Depression / drug therapy
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Electroencephalography
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Humans
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Levodopa / therapeutic use
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Male
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Mianserin / adverse effects*
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Mianserin / analogs & derivatives*
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Mirtazapine
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Neuropsychological Tests
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Parkinsonian Disorders / complications
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Parkinsonian Disorders / drug therapy*
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Polysomnography
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REM Sleep Behavior Disorder / chemically induced*
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REM Sleep Behavior Disorder / complications
Substances
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Antidepressive Agents, Tricyclic
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Mianserin
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Levodopa
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Mirtazapine