• Yanli Du, Jiajun Jiang, Chee H Ng, Lingling Wu, Peifen Zhang, Caixi Xi, Jianbo Lai, Yi Xu, Shaohua Hu, and Zheng Wang.
• Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine.
• Medicine (Baltimore). 2020 Jun 26; 99 (26): e21003.

RationaleRapid eye movement sleep behavior disorder (RBD) is a kind of sleep disturbance characterized by a loss of normal paralysis of REM sleep with dream enactment behavior during REM sleep. The pharmacotherapy options for treating RBD are limited and the use of antidepressants remains controversial. Further, the role of vortioxetine in RBD has not been evaluated so far.Patient ConcernsA 72-year-old woman presented with recurrent peculiar behaviors such as shouting, punching, kicking or even walking around her bedroom during sleep for over 3 years.DiagnosisClinical examinations and polysomnography indicated the diagnosis of RBD.InterventionsThe patient received treatment with paroxetine and melatonin for 1 year and then paroxetine was discontinued and vortioxetine was initiated in a daily dose of 10 mg.OutcomesTreatment with paroxetine and melatonin for one year was ineffective. A trial of vortioxetine 10 mg per day over 3 months resulted in significant clinical improvement.LessonsTo our knowledge, this is the first reported case of effective treatment of RBD with vortioxetine. Well-designed studies with large samples are needed to verify the clinical benefits.

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