Effects of safinamide on REM sleep behavior disorder in Parkinson disease: A randomized, longitudinal, cross-over pilot study 2021

[Bolt_Upright]

CC clued me into this. pubmed.ncbi.nlm.nih.gov/343...

Results: Twenty-two of 30 patients reported clear improvement in symptoms during safinamide treatment, and 16 were absolutely free from clinical RBD-symptoms at the end of the treatment. Eight patients reported slight improvement in RBD-symptoms. In 6/30 patients no substantial improvement was recorded about clinical RBD-symptoms had frightening dreams or from the bed after 1-week of treatment. In addition, after safinamide, the mean UPDRS-II and III scores decreased, while PDSS-2 score indicating an improvement in both motor symptoms and nocturnal sleep features. A significant reduction of sleep behavior disorder by questionnaire-Hong Kong-score (RBDQ-HS), mainly for two individual RBDQ-HK-items (dream related movements and failing out of bed) was registered.

Conclusions: This pilot study indicated that safinamide is well tolerated and improves RBD-symptom in parkinsonian.

[Bolt_Upright]

This safinamide has unpleasant interactions and side effects. medlineplus.gov/druginfo/me...

Safinamide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

nausea

difficulty falling asleep or staying asleep

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

worsening or more frequent body movements that you can not control

vision changes

hallucinations (seeing things or hearing voices that do not exist)

delusional beliefs (believing things that are not real)

agitation, hallucinations, fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea

Safinamide may cause other side effects.

[Fabnus]

That 16/30 were completely free of RBD is very impressive Bolt. Too bad we can't just go buy it.

[Bolt_Upright in reply to Fabnus]

What caught my eye was "after safinamide, the mean UPDRS-II and III scores decreased, while PDSS-2 score indicating an improvement in both motor symptoms and nocturnal sleep features". Was not expecting UPDRS improvements.

[jeffreyn]

"In 6/30 patients no substantial improvement was recorded about clinical RBD-symptoms had frightening dreams or from the bed after 1-week of treatment."

Say what? 🙂

I changed over from rasagiline to safinamide about 4 months ago. Thinking about it now, I feel that my RBD symptoms have improved since then.

[sharoncrayn]

Some of these studies you find make me LOL...a super expensive drug...about $900/month USD retail. Only 20% freaked out taking it. "safe"? "well tolerated"? Depends on who you talk to.

Xadago

In summary, the abstract and study had Italian to English problems (confusing English), very small intervention cohort made statistical significance meaningless, UPDRS score reductions were nothing special, survey questionnaire results are often questionable (to be avoided), etc.

sharon

[Bolt_Upright in reply to sharoncrayn]

Agreed. Once I saw the side effects it looked less appealing.

[jrg54321 in reply to Bolt_Upright]

The side effects look nearly identical to rasagiline and other mao-b inhibitors. Like they copied and pasted. Xadago seems hard to get in the US. Anybody have luck getting it covered by insurance in the states?