Table 2.

Alternative/investigational therapies for RBD

Pharmacotherapy	Class/mechanism	Dose range	Level of recommendation (evidence level)+
Agomelatine	Melatonin receptor agonist and selective serotonin receptor (5-HT2C 5-HT2B) antagonist	25–50 mg daily	C (4)
Sodium oxybate	CNS depressant (exact mechanism unknown, potentiates effect of GABA)	3–9 g nightly (as a single dose up to 4.5 g or 2 nightly doses)	C (4a)
Temazepam	Benzodiazepine (enhances GABA neurotransmission)	10 mg daily	C (4)
Zopiclone	Enhances GABA neurotransmission	3.75–7.5 mg nocte	C (4)
Carbamazepine	Sodium channel blocker	300–800 mg daily	C (4)
Gabapentin	Calcium channel blocker (exact mechanism unknown)	300–800 mg	C (4)
Cannabidiol	Effects via cannabinoid receptors	75–300 mg/day	C (4)
Yi-Gan San	Herbal remedy with suggested GABAergic and serotonergic properties	2.5 g 3 times daily	C (4)

Evidence level 4 = case series or poor case-control studies. Levels of recommendation: “C” denotes a medication that could be considered based on low-grade data and may be subject to revision

⁺Based on the American Academy of Sleep Medicine (AASM) classification of evidence [74]

^aRandomized controlled trial currently underway (https://clinicaltrials.gov, NCT04006925)