Testosterone not associated with violent dreams or REM sleep behavior disorder in men with Parkinson's.

We examined the relationship between testosterone levels, violent dreams, and REM sleep behavior disorder (RBD) in 31 men with Parkinson's disease (PD): 12 with clinical RBD and 19 without. All PD patients with clinical RBD experienced violent dreams, but none of the 19 non-RBD patients reported violent dreams. While dream content appears to be more aggressive in PD patients with clinical RBD, the presence of violent dreams or clinical RBD is not associated with testosterone levels in men with PD.

Phenomenology of dreams in Parkinson's disease.

Rapid eye movement sleep behavior disorder (RBD) occurs in approximately one third of patients with Parkinson's disease (PD) and is associated with a loss of muscle atonia during REM sleep and aggressive dream content. We examined the dream characteristics of PD patients to determine whether dream content differed between patients with RBD and without RBD, men and women with RBD, and men and women with PD. One hundred-twenty patients with a diagnosis of idiopathic PD were consecutively recruited from a movement disorders clinic and were assessed for RBD using clinical diagnostic criteria of the International Classification of Sleep Disorders Revised (2001).

Atypical antipsychotics in the elderly with Parkinson disease and the "black box" warning.

In the last 2 years, regulatory agencies in the UK and the USA have made recommendations and "black box" warnings, regarding the use of atypical antipsychotic drugs in the elderly because of a purported increase in risk of stroke and death in elderly demented patients. These advisories did not address the adverse effects of "typical" (first-generation) antipsychotics. In this article, the author reviews the history of these developments and raises issues that still need to be addressed by the neurologic community.