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

Mov Disord. 2012 Apr;27(4):559-61. doi: 10.1002/mds.24909. Epub 2012 Jan 30.


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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cholinesterase Inhibitors / therapeutic use*
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / complications
  • Parkinson Disease / drug therapy
  • Phenylcarbamates / therapeutic use*
  • Pilot Projects
  • Polysomnography
  • REM Sleep Behavior Disorder / drug therapy*
  • REM Sleep Behavior Disorder / etiology
  • Rivastigmine


  • Cholinesterase Inhibitors
  • Phenylcarbamates
  • Rivastigmine