Conditions associated with REM sleep behaviour disorder: Description of a hospital series. / Patologías asociadas al trastorno de conducta de sueño REM. Descripción de una serie hospitalaria.

INTRODUCTION: REM sleep behaviour disorder (RBD) is characterised by violent behaviours (screaming, kicking, vivid dreams) during REM sleep. It has a prevalence of 1% to 2% of the general population and is especially frequent in men and the population older than 60. In the last decade, RBD has been suggested to be a prodrome of neurodegenerative disease. We analysed associated neurological diseases and responses to drug treatment in 33 patients with RBD treated in the multidisciplinary sleep disorders unit at Hospital Infanta Sofía. PATIENTS AND METHODS: We conducted an observational descriptive retrospective analysis of patients diagnosed with RBD and treated in our multidisciplinary sleep disorders unit between October 2012 and December 2015. We recorded age, sex, associated diseases, and treatments administered to these patients. RESULTS: A total of 365 patients were attended at our unit, including 33 with RBD: 13 women (40%) and 20 men (60%). Mean age was 62.72 years. An associated disorder was identified in 48%, with the most common being mild cognitive impairment (69%). The percentage of patients with RBD and an associated disorder among patients older than 60 was 68%. Eighty-two percent of the patients required treatment. The most commonly used drug was clonazepam (76%), followed by melatonin (9%), gabapentin (6%), and trazodone (3%). DISCUSSION: In our series, 48% of the patients had an associated disorder. The likelihood of detecting an associated disorder increases with patients' age. The vast majority of patients required drug treatment due to symptom severity; the most frequently administered drug was clonazepam (76%).

[Effectiveness and safety of gabapentin in the preventive treatment of migraine]. / Eficacia y seguridad de la gabapentina en el tratamiento preventivo de la migraña.

INTRODUCTION: Migraine is a frequent and disabling pathological condition with important socioeconomic repercussions. Recent studies have explored the use of antiepileptic drugs in the prophylactic treatment of migraine. Preliminary studies have shown that gabapentin is a drug that is effective and well tolerated by patients. AIM. To evaluate the effectiveness and safety of gabapentin in the prophylactic treatment of migraine. PATIENTS AND METHODS: A prospective, open, multicentre, random clinical study, carried out according to IHS criteria, which compares the effectiveness and safety of gabapentin in 1,200 mg/day and 2,000 mg/day doses as a preventive treatment for migraine over a 16 week period. RESULTS: Significant differences were found in patients treated with gabapentin, as compared with their basal state, in the following: a lower number of attacks (reduction in weeks 4, 10 and 16: 2.4 2.8, 2.9 2.9 and 3.1 2.9 attacks/month on a basal rate of 5.3 3.5 attacks/month), lower intensity (on a scale of 0 3 of increasing pain intensity: basal rate: 2.7 0.4, week 4: 1.8 0.9, week 10: 1.7 0.9, week 16: 1.4 1.0) and how long the pain lasts (basal rate 390 hours/month, week 4: 180 hours/month, week 10: 180 hours/month, week 16: 120 hours/month). No statistically significant differences were found between doses of 1,200 or 2,000 mg/day. Mild adverse effects were seen in 62 patients (37.8%): drowsiness (22.6%), asthenia (7.9%), dizziness (4.9%), abdominal pain (3.7%) and dazedness (3.7%). No serious adverse events occurred. CONCLUSIONS: Gabapentin can be considered an effective and safe drug in the preventive treatment of migraine.

Eficacia y seguridad de la gabapentina en el tratamiento preventivo de la migraña / Effectiveness and safety of gabapentin in the preventive treatment of migraine

Introducción. La migraña es una patología frecuente e incapacitante con grandes repercusiones socioeconómicas. Recientemente se estudia el uso de fármacos antiepilépticos en la profilaxis de la migraña. Estudios preliminares han demostrado que la gabapentina es un fármaco efectivo y bien tolerado por los pacientes. Objetivo. Evaluar la eficacia y la seguridad de la gabapentina en la profilaxis de la migraña. Pacientes y métodos. Estudio clínico prospectivo, abierto, multicéntrico y aleatorio, con 164 pacientes migrañosos, según criterios de la IHS, que compara la eficacia y seguridad de gabapentina en dosis de 1.200 mg/día y 2.000 mg/día, como tratamiento preventivo de la migraña, durante 16 semanas. Resultados. Se encontraron diferencias significativas en los pacientes tratados con gabapentina, respecto a su estado basal, en: reducción del número de crisis (reducción en las semanas 4, 10 y 16: -2,4ñ2,8, -2,9ñ2,9 y -3,1ñ2,9 crisis/mes sobre un basal de 5,3ñ3,5 crisis/mes), disminución de la intensidad (sobre una escala 0-3 de intensidad ascendente de dolor: puntuación basal: 2,7ñ0,4, semana 4: 1,8ñ0,9, semana 10: 1,7ñ0,9, semana 16: 1,4ñ1,0) y de la duración de dolor (basal de 390 horas/mes, semana 4: 180 horas/mes, semana 10: 180 horas/mes, semana 16: 120 horas/mes). No se encontraron diferencias estadísticamente significativas entre dosis de 1.200 o 2.000 mg/día. Se registraron efectos adversos de carácter leve en 62 pacientes (37,8 por ciento): somnolencia (22,6 por ciento), astenia (7,9 por ciento), mareo (4,9 por ciento), dolor abdominal (3,7 por ciento) y aturdimiento (3,7 por ciento). No hubo ningún acontecimiento adverso grave. Conclusiones. La gabapentina puede considerarse un fármaco eficaz y seguro en la profilaxis de la migraña (AU)