Question:
I got this info from "Dr.Bob's Psychopharmacology Tips" at
http://uhs.bsd.uchicago.edu/dr-bob/tips/tips.html
.
Some good info here.....especially for those suffering from sleep
problems caused by SSRI's!!
Answer:
I have had RBD - mostly it occurs in older men (50+) with neurological
disorders, but it's starting to be noticed with the new antidepressants. SSRIs
and Effexor apparently can cause it (this was mentioned in my sleep class last
week, in fact), as can withdrawal from MAOIs or amphetamines. (Dunno about
benzos.) Klonopin is the main treatment at present, but there are some other
things that might work. It actually is pretty important to get treatment of
some sort for this, as people have been known to get seriously hurt (or even to
hurt their "bed buddies") as a result of RBD events. (I've heard of people
taking drastic measures, such as tying themselves to the bed, to prevent this!)
RBD dreams do tend to be "action-packed" and while the diagnosis can be
confirmed by a sleep study, it's probably going to be pretty obvious to you if
you are awakened during an episode that what you were doing was acting out the
dream. Awakening during episodes isn't uncommon; you're liable to wake up from
REM sleep (the lightest phase of sleep) when you leap from your bed and go
crashing to the floor, or when you punch your partner in the face, elicitng a
loud yelp.
BTW, if you're taking an SSRI that's causing this, the sleep disorder should go
away if you stop the SSRI, so switching to another type of antidepressant is
something to consider. MAOIs should prevent RBD, although withdrawal will cause
it if you don't taper off the MAOI slowly. (Like SSRIs, MAOIs blunt or
eliminate REM atonia, but they also suppress REM almost completely - SSRIs do
suppress REM somewhat, but you still spend enough time in REM to cause problems
if you're moving about during it.) I don't know about tricyclics offhand.
