Sertraline Associated with REM Sleep Behavior Disorder: A Case Report

2019 ◽  
Vol 8 (2) ◽  
pp. 159-162 ◽  
Author(s):  
Seyed Mostafa Mansouripour ◽  
Dharmendra Kumar
Keyword(s):  
Case Report ◽  
Rem Sleep ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Motor Behavior ◽  
Antidepressant Medication ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Cord Injury ◽  
History Of

Background: REM sleep behavior disorder (RBD) is manifested by abnormal motor behavior with an endurance of tone during REM sleep. Studies suggest that patients taking Selective serotonin reuptake inhibitors (SSRIs) are at greater risk of developing REM sleep behavior disorder. Case Presentation: We present a case of 39-year-old female with a past medical history of spinal cord injury from a gunshot wound 19 years ago resulting in paraplegia, posttraumatic stress disorder(PTSD), chronic pain, and chronic sleep problem. After sertraline started and up-titrated to 200 mg for her anxiety, she noticed worsening of her nighttime sleep behavior. Her mother also witnessed sleepwalking episode and doing things which the patient had no recollection in the morning, including trying to take a bath and eat from the refrigerator. On her follow-up appointment, her sertraline was discontinued altogether and she was started on Escitalopram 5 mg. She tolerated the medication well, it helped moderately with her anxiety and by the time of this case report (approximately 1 month) patient did not report any sleep-related behavior. Conclusion: Since antidepressant medication is very commonly prescribed, it is important to be cautious of physiologic changes they may induce, even if the clinical significance of these changes is not fully elucidated. In addition, RBD may predict neurodegenerative disorders a couple of years earlier, so it may be used as an effective early marker of neurodegenerative diseases.

scholarly journals 23 “To die, to sleep – to sleep, perchance to dream..." Inhibition of Nightmares with Pramipexole: A Possible Treatment for PTSD

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 185-186 ◽  
Author(s):  
Freddy Escobar-Montealegre ◽  
Preet Brar ◽  
Alan Richard Hirsch
Keyword(s):  
Rem Sleep ◽  
Motor Behavior ◽  
Symptom Control ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Therapeutic Interventions ◽  
Post Traumatic Stress ◽  
Pharmacologic Agent ◽  
Sleep Behavior ◽  
Abductor Digiti Minimi

AbstractIntroductionThe association of sleep disorders and post-traumatic stress disorder (PTSD) is almost universal. Nightmares are not only one of the most commonly associated but also featured as a diagnostic criterion for PTSD. PTSD-related nightmares are particularly distressing, may impair functioning and increase risk of suicide. No specific pharmacologic agent has been demonstrated to impair dreaming. Inhibition of PTSD-related nightmares with pramipexole has not heretofore been described. Such a case is presented.MethodsCase study - This 60 year-old male with PTSD and trauma-related nightmares upon introduction of pramipexole 0.5mg PO qHS for Restless Leg Syndrome (RLS) had total elimination of dreams, which recurred upon discontinuation of this agent as a result of insomnia and increased anxiety. A lower dose of 0.375mg qHS provided optimal RLS-symptom control and overall improved tolerance despite nightmare recurrence.ResultsAbnormalities on Neurological examination: Recent recall: 2 of 4 objects without improvement with reinforcement. Able to spell the word “world” forwards but not backwards. Abstract thought impaired. Chemosensory testing: Anosmia and normogeusia. Motor: Drift: mild right pronator drift with right cerebellar spooning and right abductor digiti minimi sign. Reflexes: 3+ brachioradialis and biceps bilaterally, absent ankle jerks. Other: CT scan with and without contrast: normal.DiscussionNightmares related to PTSD may occur during Rapid Eye Movement (REM) sleep and non-REM sleep. Underlying sympathetic activation may lead to disruptive motor behavior similar to that seen in REM sleep behavior disorder. The exact mechanism of action by which inhibition of dreams occurred with use of pramipexole is unclear. Such a response is consistent with prior documented evidence of REM sleep suppression with low-dose pramipexole such as it‘s efficacy in reducing the intensity and frequency of nightmares and dream enactment related to REM sleep behavior disorder. Further research on therapeutic interventions that target nightmares directly may be beneficial for the management of patients with PTSD.

scholarly journals Risk factors for possible REM sleep behavior disorders

Neurology ◽  
2020 ◽  
Vol 95 (16) ◽  
pp. e2214-e2224
Author(s):  
Hui Zhang ◽  
Zhuqin Gu ◽  
Chun Yao ◽  
Yanning Cai ◽  
Yuan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Rem Sleep ◽  
Positive Family History ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Multivariable Logistic Regression Analysis ◽  
Co Poisoning ◽  
Sleep Behavior ◽  
History Of

ObjectiveTo explore the risk factors for idiopathic REM sleep behavior disorder (RBD) in a community population in Beijing.MethodsParticipants aged 55 years and above were recruited from the Beijing Longitudinal Study on Aging II cohort. We identified individuals with possible RBD (pRBD) using the validated RBD Questionnaire–Hong Kong in 2010. A series of environmental, lifestyle, and other potential risk factors were assessed via standardized questionnaires in 2009. Multivariable logistic regression analysis was performed to investigate the association between the studied factors and pRBD.ResultsOf 7,225 participants who were free of parkinsonism and dementia, 219 (3.0%) individuals were considered as having pRBD. Participants with pRBD reported more nonmotor and motor symptoms of Parkinson disease (PD) with adjusted odds ratios (ORs) ranging from 1.10 to 4.40. Participants with pRBD were more likely to report a family history of parkinsonism or dementia (OR 3.03, 95% confidence interval [CI] 1.23–7.46). There was a significant association between pRBD and self-reported hyperlipidemia (OR 1.51, 95% CI 1.09–2.10), ever smoking (OR 1.79, 95% CI 1.20–2.65), prior carbon monoxide (CO) poisoning (OR 2.30, 95% CI 1.39–3.83), and nonoccupational exposure to pesticides (OR 2.21, 95% CI 1.40–3.50).ConclusionOur study replicated previously reported associations between pRBD and hyperlipidemia, smoking, pesticide exposure, and several prodromal PD symptoms. We also found previously unreported links with a positive family history of parkinsonism or dementia and CO poisoning. Risk factor profiles for pRBD partially resemble those defined for PD, but also differ in distinct ways.

REM sleep behavior disorder predisposed by neuroleptic malignant syndrome: a case report

2018 ◽  
Vol 17 (1) ◽  
pp. 155-157 ◽  
Author(s):  
Michiko Konno ◽  
Takahiro Suzuki ◽  
Tadashi Kanamori ◽  
Ryuji Furihata ◽  
Hiromi Yokose ◽  
...  
Keyword(s):  
Case Report ◽  
Neuroleptic Malignant Syndrome ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior
Sign in / Sign up

Export Citation Format

Share Document