包括氯硝西泮在内的苯二氮卓类药物在治疗成人不宁腿综合征和睡眠中周期性肢体运动中的作用的历史概述》(A Historical Overview of the Role of Benzodiazepines including Clonazepam in the Treatment of Adult Restless Legs Syndrome and Periodic Limb Movements in Sleep.

IF 2.5 Q2 CLINICAL NEUROLOGY
Tremor and Other Hyperkinetic Movements Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI:10.5334/tohm.824
Arthur S Walters, Karen Spruyt, Djibril M Ba, Xiang Gao
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引用次数: 0

摘要

最近,我们对 16,694 名接受不宁腿综合症 (RLS) 治疗的患者进行了调查,其中约 25% 的患者单独或与其他 RLS 治疗药物联合使用苯二氮卓类药物。由于接受苯二氮卓类药物治疗 RLS 的人数众多,我们对苯二氮卓类药物在 RLS 及其相关疾病睡眠中周期性肢体运动(PLMS)中的治疗作用进行了历史回顾。我们找到了 17 篇关于氯硝西泮用于 RLS、PLMS 或两者的文章,3 篇关于三唑仑和 PLMS,1 篇关于阿普唑仑和 RLS,1 篇关于替马西泮和 PLMS,1 篇关于硝西泮和 PLMS。根据文献总结,苯二氮卓类药物的获益顺序为睡眠>RLS>PLMS,唤醒>PLMS。大多数关于氯硝西泮的研究都采用了 0.5-2.0 毫克的剂量。3 或 4 毫克的剂量会导致昏睡、嗜睡和精神错乱。一项关于 RLS 治疗的流行病学研究表明,使用大多数类型的 RLS 药物(包括苯二氮卓类药物)结合其他 RLS 治疗方法来治疗 RLS,可以降低未来与 RLS 相关的心血管风险。苯二氮卓类药物的主要作用是增强 GABA 对 GABA A 受体的作用。神经影像学研究表明,GABA 在 RLS 患者的不同脑区会发生正向或负向改变,遗传学研究表明,RLS 患者的 GABA 受体会发生改变。这些结果表明,噻加宾(Gabitril)等具有不同GABA能机制的药物应在RLS中进行研究,以确定其可能的治疗效果:苯二氮卓类药物常用于治疗不宁腿综合征(RLS)和睡眠中的周期性肢体运动。受益顺序为睡眠>RLS>PLMS,唤醒>PLMS。氯硝西泮最常用的剂量为 0.5 毫克-2.0 毫克/天。苯二氮卓类药物通过 GABA 能机制发挥治疗作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Historical Overview of the Role of Benzodiazepines including Clonazepam in the Treatment of Adult Restless Legs Syndrome and Periodic Limb Movements in Sleep.

In a recent survey of 16,694 people receiving treatment for Restless Legs Syndrome (RLS), approximately 25% were treated with benzodiazepines either singly or in combination with other RLS treatments. Because of the large number of people receiving benzodiazepines for treatment of RLS, we conducted a historical overview of the therapeutic role of benzodiazepines in RLS and its associated condition Periodic Limb Movements in Sleep (PLMS). We found 17 articles on the use of clonazepam in RLS, PLMS, or both, 3 on triazolam and PLMS, 1 on alprazolam and RLS, 1 on temazepam and PLMS, and 1 on nitrazepam and PLMS. The order of benefit of benzodiazepines from the summarized literature is Sleep>RLS>PLMS and arousals > PLMS. Most of the studies on clonazepam employed dosages of 0.5-2.0 mg. Dosages of 3 or 4 mg caused lethargy, somnolence and confusion. An epidemiological study on the therapy of RLS suggests that treatment of RLS with most types of RLS medications including benzodiazepines in combination with other RLS therapies lowers the future cardiovascular risk associated with RLS. The major effect of benzodiazepines is through potentiation of the effect of GABA on the GABA A receptor. Neuroimaging studies suggest that GABA is altered either positively or negatively in various brain regions in RLS and genetic studies suggest that there are alterations in the GABA receptor in RLS. These results suggest that medications with different GABAergic mechanisms such as tiagabine (Gabitril) or others should be investigated in RLS for their possible therapeutic benefit.

Highlights: Benzodiazepines are frequently used as therapy in Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep. The order of benefit is Sleep>RLS>PLMS and arousals > PLMS. For clonazepam dosages of 0.5 mg-2.0 mg/day are most frequently employed. Benzodiazepines exert their therapeutic effect through GABA-ergic mechanisms.

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CiteScore
4.00
自引率
4.50%
发文量
31
审稿时长
6 weeks
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