Nocturnal Myoclonus: Treatment Efficacy of Clonazepam and Temazepam

Abstract

Clonazepam (1 mg h.s.) and temazepam (30 mg h.s.) were studied in 10 patients diagnosed as having insomnia with nocturnal myoclonus. Each subject underwent two nocturnal polysomnographic recordings while drug-free, two during treatment with clonazepam, and two during treatment with temazepam. Treatment sessions were 7 days long, and recordings were done on nights 6 and 7 of the treatment sessions. A 14-day washout period separated the treatment sessions. The order of drugs used in the first and second treatment sessions was randomized. Objective and subjective sleep laboratory data showed that both drugs improved the sleep of patients with insomnia in association with nocturnal myoclonus. Neither drug significantly reduced the number of nocturnal myoclonic events. Sleep changes were consistent with those produced by sedative benzodiazepines in general. Thus, the data support clinical reports that clonazepam, a benzodiazepine marketed for the indication of seizure, is useful in improving sleep disturbances associated with nocturnal myoclonus. Temazepam, a benzodiazepine marketed for the indication of insomnia, was found to be a suitable alternative to clonazepam in the treatment of insomnia associated with nocturnal myoclonus. The present data and other studies suggest the need for a model that explains why leg movements and sleep disturbances may wax and wane independently.

Self-reported depressive symptomatology, mood ratings, and treatment outcome in sleep disorders patients

“…The increased Anger scores, however, in all three evaluations that followed the initial drug-free assessment could reflect the voiced dissatisfaction by more than half of the PLM/RLS group that relief from restless legs, sleep disturbance, and fatigue was not complete on clonazepam. Patient dissatisfaction with clonazepam has been reported before (Coleman, 1982) and may relate to the inefficacy of the drug in eliminating the leg movements despite significantly improved sleep consolidation (Mitler et al, 1986).…”

Pergolide: treatment of choice in restless legs syndrome (RLS) and nocturnal myoclonus syndrome (NMS). A double-blind randomized crossover trial of pergolide versus L-Dopa

“…The L-Dopa medication was withdrawn 3 days prior to entering the study. The temazepam medication was continued in the three patients during the whole investigation, since it is known that the NMS activity is not effected by temazepam (Mitler et al, 1986). Over a 16-day period, patients were given a daily dose of L-Dopa + Carbidopa (250 rag) or Pergolide (0.125 mg) 1 to 3 hours prior to sleep.…”

Can chronic neuroleptic treatment promote sleep disturbances in elderly schizophrenic patients?

“…In addition, it should be noted that ®ve of our patients were also on benzodiazepines and anticholinergics, which could have in¯uenced the results. But the NMS was found in all patients, and it therefore seems unlikely that its occurrence can be attributed to the eects of these concomitant medications, especially since it is known that the NMS is not aected by benzodiazepines (Mitler et al, 1986).…”