From the Guidelines
Onreltea is not mentioned in the provided evidence, however, based on the context of the question, it appears that the correct term might be "Oreltea" or a similar medication, but since there is no information available on "Onreltea" or "Oreltea", I will provide information on a medication that is used to treat a similar condition, such as REM sleep behavior disorder (RBD).
Treatment of REM Sleep Behavior Disorder
The treatment of RBD typically involves the use of medications such as clonazepam, melatonin, pramipexole, and rivastigmine 1.
- Clonazepam is a long-acting benzodiazepine that promotes GABAergic inhibition by increasing the frequency of chloride channel opening.
- Melatonin binds to the M1 and M2 receptors, suppressing REM sleep motor tone and renormalizing other circadian features of REM sleep.
- Pramipexole is a dopaminergic agonist typically used to treat the motor symptoms of PD, RLS, and periodic limb movement disorder.
- Rivastigmine, an acetylcholinesterase inhibitor, is commonly employed in the treatment of DLB and PD dementia.
Dosage and Administration
The dosage and administration of these medications vary depending on the patient's condition and response to treatment.
- Clonazepam is typically started at a low dose (0.25-1.0 mg) administered at bedtime, with higher doses considered in the absence of response if well tolerated.
- Melatonin is usually started at 3 mg taken at bedtime, with the dose titrated up to address dream enactment in 3-mg increments to 15 mg.
- Pramipexole is typically started at 0.125 mg administered orally at bedtime and can be increased slowly to 2.0 mg nightly.
- Rivastigmine is commonly employed in the treatment of DLB and PD dementia, with the most notable side effects including site reaction, gastrointestinal symptoms of nausea and diarrhea, bradycardia, and possible excessive daytime sleepiness in this patient population 1.
Side Effects and Considerations
The side effects and considerations of these medications should be carefully evaluated when choosing a treatment option.
- Clonazepam can cause morning sedation, gait imbalance/falls, depression, and cognitive disturbances, specifically delirium and amnesia.
- Melatonin can cause vivid dreams and sleep fragmentation, which only rarely result in discontinuation.
- Pramipexole may reduce dream enactment by treating an underlying sleep-fragmenting condition, periodic limb movement disorder.
- Rivastigmine may be an appropriate choice for patients with RBD and cognitive impairment refractory to other treatments.
From the Research
Onreltea Usage
- Onreltea is not explicitly mentioned in the provided studies 2, 3, 4, 5, 6
- The studies focus on myelodysplastic syndromes (MDS), acute myeloid leukemia (AML), and various treatments such as hypomethylating agents, lenalidomide, and allogeneic stem cell transplantation
- There is no direct information available on the usage of Onreltea in the context of MDS or AML treatment
Related Treatments
- Hypomethylating agents like azacitidine and decitabine are used to treat high-risk MDS and AML 3, 6
- Lenalidomide is used to treat lower-risk MDS with anemia and a chromosome 5 alteration 2
- Allogeneic stem cell transplantation is a treatment option for higher-risk MDS and AML 2, 4