Clonazepam (Klonopin) is highly effective in the treatment of REM sleep behavior disorder (RBD), relieving symptoms in nearly 90% of patients with little evidence of tolerance or abuse. The response usually begins within the first week, often on the first night. The initial dose is 0.5 mg at bedtime, with some persons requiring a rapid increase to 1 mg. With continued treatment for years, moderate limb twitching with sleep talking and more complex behaviors can reemerge. The treatment should be continued indefinitely, as violent behaviors and nightmares promptly recur with discontinuation of medications in almost all persons with RBD.

Other medications, such as tricyclic antidepressants, may be effective in some persons with RBD. However, tricyclics are also known to precipitate RBD in some patients.

Reviewed by Michael W. Smith, MD on November 01, 2006

Sleep Disorders Guide

Overview & Facts

Symptoms & Types

Diagnosis & Tests

Treatment & Care

Living & Managing

Support & Resources

Depression Symptoms — Treatment May Help

Important Safety Information Full Prescribing Information

Real Migraines, Real People

Learn How TOPAMAX Can Help from Patients Who Have Been There

Important Safety Information | Prescribing Information

TOPAMAX is approved for migraine prevention in adults only.
TOPAMAX is not used to stop a migraine after it starts.

IMPORTANT SAFETY INFORMATION

Serious risks associated with TOPAMAX include lowered bicarbonate levels in the blood resulting in an increase in the acidity of the blood (metabolic acidosis). Symptoms could include hyperventilation (rapid, deep breathing), tiredness, loss of appetite, irregular heartbeat or changes in the level of alertness. Call your doctor immediately if you get these symptoms. Your doctor may want to do simple blood tests. Chronic, untreated metabolic acidosis may increase the risk for kidney stones or bone disease.

Other serious risks include decreased sweating, increased body temperature, kidney stones, sleepiness, dizziness, confusion, difficulty concentrating, and increased eye pressure (glaucoma). Call your doctor immediately if you have any decrease in vision or eye pain. These problems can lead to blindness if not treated right away.

More common side effects are tingling in arms and legs, loss of appetite, tiredness, nausea, diarrhea, taste change and weight loss.

Tell your doctor about other medications you take. Please see full U.S. Prescribing Information.

WebMD does not endorse any specific product, service, or treatment.