The purpose of this page is to provide exposure to different and less publicized aspects of SSRI's & SNRI's. The articles will change periodically so check back often for the next installment.
It's not always the dancing serotonin bubble........
REM Behavioral Disorder
Authors report the results of a study involving a sleep lab investigation of 15 subjects receiving a serotonergic antidepressant (prozac, paxil, celexa, Zoloft, effexor) vs. 15 age –matched controls not taking any such medication. Subjects were recruited from a polysmonography database at Sleep Health Centers in Newton Center, MA.The investigators performed a chart review, analyzing clinical and sleep data for subjects referred to their center for the evaluation of a sleep disorder.None of the subjects included in the study were diagnosed with sleep apnea, which was the primary reason for referral.The investigators performed a retrospective analysis of the sleep studies, concentrating on EMG tone (muscle tone) changes during REM sleep in individuals receiving chronic treatment with serotonergic antidepressants.Interestingly, these were subjects who did not have any complaints of abnormal behavior during sleep.Findings were significant for increased submental activity during REM among subjects taking antidepressants, with 13% of the subjects in this study exceeding Gagnon’s criteria for REM sleep behavior disorder (RBD); 53% exceeding Eisensehr’s criteria for RBD.The authors of this study conclude that the clinical status of REM sleep without atonia – as seen in their patient sample – remains ambiguous. Even so, they express their concerns that REM sleep without atonia may be an early stage of RBD.They suggest that there are substantial potential public health implications of REM sleep abnormalities in individuals taking serotonergic antidepressants, particularly in the context of more than 10 million people in the US alone taking these drugs.
[Note: the significance of RBD is as follows: during normal REM sleep, the muscle tone of the body is inhibited or “turned off” so that the sleeper does not act out, physically, the scenes of a dream.RBD is a form of “wakeful dreaming” during which a person is technically asleep, but moving – it can lead to the enactment of violent or otherwise injurious behaviors, as the person literally acts out his or her dreams.]