Skip to main content
SpringerLink
Log in

SSRIs and Sleep in Man

  • Chapter
Sleep and Sleep Disorders

Conclusions

SSRIs have marked dose-dependent effects on REM sleep in healthy volunteers and depressed patients, with REM onset latency being lengthened and REM amount being reduced. After weeks of treatment REM latency remains long, but the amount of REM recovers, and shows rebound after withdrawal. These changes in amount of REM sleep may reflect receptor adaptation.

Sleep continuity is worsened by SSRIs, with time awake after sleep onset and stage 1 sleep being increased early in treatment. Effects are more marked in normal volunteers than in depressed patients, probably because normal volunteers have better baseline sleep. This worsening in sleep recovers after a few days in depressed patients.

In general the deterioration in sleep continuity is not paralleled by a worsening of subjective ratings of sleep, which improve during SSRI treatment of depression.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Thase ME. Antidepressant treatment of the depressed patient with insomnia. J Clin Psychiatry 1999; 60(Suppl 17):28–31.

    CAS  PubMed  Google Scholar 

  2. Thase ME, Buysse DJ, Frank E et al. Which depressed patients will respond to interpersonal psychotherapy? The role of abnormal EEG sleep profiles. Am J Psychiatry 1997; 154(4):502–9.

    CAS  PubMed  Google Scholar 

  3. *Feige B, Voderholzer U, Riemann D et al. Fluoxetine and sleep EEG: Effects of a single dose, subchronic treatment, and discontinuation in healthy subjects. Neuropsychopharmacology 2002; 26(2):246–58.

    Article  CAS  PubMed  Google Scholar 

  4. *van Bemmel AL, van den Hoofdakker RH, Beersma DGM et al. Changes in sleep polygraphic variables and clinical state in depressed patients during treatment with citalopram. Psychopharmacology 1993; 113:225–230.

    Article  PubMed  Google Scholar 

  5. *Rush AJ, Armitage R, Gillin JC et al. Comparative effects of nefazodone and fluoxetine on sleep in outpatients with major depressive disorder. Biol Psychiatry 1998; 44(1):3–14.

    Article  CAS  PubMed  Google Scholar 

  6. Borbely AA. A two process model of sleep regulation. Hum Neurobiol 1982; 1(3):195–204.

    CAS  PubMed  Google Scholar 

  7. Ehlers CL, Havstad JW, Kupfer DJ. Estimation of the time course of slow-wave sleep over the night in depressed patients: Effects of clomipramine and clinical response. Biol Psychiatry 1996; 39(3):171–81.

    Article  CAS  PubMed  Google Scholar 

  8. Veitch W, Wilson SJ, Argyropoulos S et al. Slow waves in sleep are altered by paroxetine and nefazodone in depressed patients. J Psychopharm 2001; 15(3 suppl):A18.

    Google Scholar 

  9. Monaca C, Boutrel B, Hen R et al. 5-HT 1A/1B receptor-mediated effects of the selective serotonin reuptake inhibitor, citalopram, on sleep: Studies in 5-HT 1A and 5-HT 1B knockout mice. Neuropsychopharmacology 2003; 28(5):850–6.

    CAS  PubMed  Google Scholar 

  10. Monti JM, Monti D. Role of dorsal raphe nucleus serotonin 5HT1a receptor in the regulation of REM sleep. Life Sciences 2000; 66:1999–2012.

    Article  CAS  PubMed  Google Scholar 

  11. *Wilson SJ, Bailey JE, Rich AS et al. Effects of 5HT1A agonists on sleep in normal volunteers: A comparison of eptapirone, buspirone, and placebo. J Psychopharm 2003; 17(3 suppl):A73.

    Google Scholar 

  12. *Hicks JA, Argyropoulos SV, Rich AS et al. Randomised controlled study of sleep after nefazodone or paroxetine treatment in out-patients with depression. Br J Psychiatry 2002; 180:528–35.

    Article  CAS  PubMed  Google Scholar 

  13. *Vasar V, Appelberg B, Rimon R et al. The effect of fluoxetine on sleep: A longitudinal double blind polysomnographic study of healthy volunteers. International Clinical Psychopharmacology 1994; 9:203–206.

    Article  CAS  PubMed  Google Scholar 

  14. *Wilson SJ, Bailey JE, Alford C et al. Effects of 5 weeks of administration of fluoxetine and dothiepin in normal volunteers on sleep, daytime sedation, psychomotor performance and mood. J Psychopharmacol 2002; 16(4):321–31.

    Article  CAS  PubMed  Google Scholar 

  15. Argyropoulos SV, Hicks JA, Nash Jr et al. Correlation of subjective and objective sleep measurements at different stages of the treatment of depression. Psychiatry Res 2003; 120(2):179–90.

    Article  PubMed  Google Scholar 

  16. *Wilson SJ, Bell C, Coupland NJ et al. Sleep changes during long-term treatment of depression with fluvoxamine-A home based study. Psychopharmacology 2000; 149:360–365.

    Article  CAS  PubMed  Google Scholar 

  17. Ridout F, Meadows R, Johnsen S et al. A placebo controlled investigation into the effects of paroxetine and mirtazapine on measures related to car driving performance. Hum Psychopharmacol 2003; 18(4):261–9.

    Article  CAS  PubMed  Google Scholar 

  18. Ohayon MM, Roth T. Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 2002; 53(1):547–54.

    Article  PubMed  Google Scholar 

  19. Schenck CH, Mahowald MW, Kim SW et al. Prominent eye movements during NREM sleep and REM sleep behavior disorder associated with fluoxetine treatment of depression and obsessive-compulsive disorder. Sleep 1992; 15(3):226–35.

    CAS  PubMed  Google Scholar 

  20. Ellison JM, Stanziani P. SSRI-associated nocturnal bruxism in four patients. J Clin Psychiatry 1993; 54(11):432–4.

    CAS  PubMed  Google Scholar 

  21. Pagel JF, Helfter P. Drug induced nightmares—An etiology based review. Hum Psychopharmacol 2003; 18(1):59–67.

    Article  CAS  PubMed  Google Scholar 

  22. Lepkifker E, Dannon PN, Iancu I et al. Nightmares related to fluoxetine treatment. Clin Neuropharmacol 1995; 18:90–94.

    Article  CAS  PubMed  Google Scholar 

  23. Markowitz JC. Fluoxetine and dreaming. J Clin Psychiatry 1991; 52(10):432.

    CAS  PubMed  Google Scholar 

  24. Koponen, H, Lepola U, Leiononen E et al. Citalopram in the treatment of obsessive-compulsive disorder: An open pilot study. Acta Psychiat Scand 1997; 96:343–346.

    Article  CAS  PubMed  Google Scholar 

  25. Kirschner NT. Medication and dreams: Changes in dream content after drug treatment. Dreaming 1999; 9:195–200.

    Article  Google Scholar 

  26. Pace-Schott EF, Gersh T, Silvestri R et al. SSRI treatment suppresses dream recall frequency but increases subjective dream intensity in normal subjects. J Sleep Res 2001; 10(2):129–42.

    Article  CAS  PubMed  Google Scholar 

  27. Stein DJ, Davidson J, Seedat S et al. Paroxetine in the treatment of post-traumatic stress disorder: Pooled analysis of placebo-controlled studies. Expert Opin Pharmacother 2003; 4(10):1829–38.

    Article  CAS  PubMed  Google Scholar 

  28. Nowell PD, Reynolds CF 3rd, Buysse DJ et al. Paroxetine in the treatment of primary insomnia: Preliminary clinical and electroencephalogram sleep data. J Clin Psychiatry 1999; 60(2):89–95.

    CAS  PubMed  Google Scholar 

  29. Goldenberg D, Mayskiy M, Mossey C et al. A randomized, double-blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia. Arthritis Rheum 1996; 39(11):1852–9.

    Article  CAS  PubMed  Google Scholar 

  30. Vercoulen JH, Swanink CM, Zitman FG et al. Randomised, double-blind, placebo-controlled study of fluoxetine in chronic fatigue syndrome. Lancet 1996; 347(9005):858–61.

    Article  CAS  PubMed  Google Scholar 

  31. Wilson SJ, Lillywhite AR, Potokar JP et al. Adult night terrors and paroxetine. Lancet 1997; 350(9072):185.

    Article  CAS  PubMed  Google Scholar 

  32. Bengtson H, Broman J-E, Hetta J. The effect of paroxetine on sleepwalking in 8 adults. Sleep Research Online 1999; 2(S1):131.

    Google Scholar 

  33. Kopelman PG, Elliott MW, Simonds A et al. Short-term use of fluoxetine in asymptomatic obese subjects with sleep-related hypoventilation. Int J Obes Relat Metab Disord 1992; 16(10):825–30.

    CAS  PubMed  Google Scholar 

  34. Kraiczi H, Hedner J, Dahlof P et al. Effect of serotonin uptake inhibition on breathing during sleep and daytime symptoms in obstructive sleep apnea. Sleep 1999; 22(1):61–7.

    CAS  PubMed  Google Scholar 

  35. Hanzel DA, Proia NG, Hudgel DW. Response of obstructive sleep apnea to fluoxetine and protriptyline. Chest 1991; 100(2):416–21.

    Article  CAS  PubMed  Google Scholar 

  36. Manfredi RL, Kales A, Vgontzas AN et al. Buspirone: Sedative or stimulant effect? Am J Psychiatry 1991; 148(9):1213–7.

    CAS  PubMed  Google Scholar 

  37. Gillin JC, Sohn JW, Stahl SM et al. Ipsapirone, a 5-HT1A agonist, suppresses REM sleep equally in unmedicated depressed patients and normal controls. Neuropsychopharmacology 1996; 15(2):109–15.

    Article  CAS  PubMed  Google Scholar 

  38. Ware JC, Rose FV, McBrayer RH. The acute effects of nefazodone, trazodone and buspirone on sleep and sleep-related penile tumescence in normal subjects. Sleep 1994; 17(6):544–50.

    CAS  PubMed  Google Scholar 

  39. Gillin JC, Jernajczyk W, Valladares-Neto DC et al. Inhibition of REM sleep by ipsapirone, a 5HT1A agonist, in normal volunteers. Psychopharmacology (Berl) 1994; 116(4):433–6.

    Article  CAS  PubMed  Google Scholar 

  40. Seifritz E, Moore P, Trachsel L et al. The 5-HT1A agonist ipsapirone enhances EEG slow wave activity in human sleep and produces a power spectrum similar to 5-HT2 blockade. Neurosci Lett 1996; 209(1):41–4.

    Article  CAS  PubMed  Google Scholar 

  41. Driver HS, Flanigan MJ, Bentley AJ et al. The influence of ipsapirone, a 5-HT1A agonist, on sleep patterns of healthy subjects. Psychopharmacology (Berl) 1995; 117(2):186–92.

    Article  CAS  PubMed  Google Scholar 

  42. Moore P, Seifritz E, Schlosser A et al. Rapid tryptophan depletion plus a serotonin 1A agonist: Competing effects on sleep in healthy men. Neuropsychopharmacology 2001; 25(5 Suppl):S40–4.

    Article  CAS  PubMed  Google Scholar 

  43. Ansseau M, Pitchot W, Gonalez-Moreno A. Flesinoxan, a 5HT1A agonist, in major depression: Clinical efficacy and effects on REM latency and body temperature (open study). European Neuropsychopharmacology 1992; 2:313.

    Article  Google Scholar 

  44. *Wilson SJ, Bailey JE, Rich AS et al. Using sleep to evaluate comparative serotonergic effects of paroxetine and citalopram. Eur Neuropsychopharmacol 2004; 14(5):367–72.

    Article  CAS  PubMed  Google Scholar 

  45. *Bell C, Wilson S, Rich A et al. Effects on sleep architecture of pindolol, paroxetine and their combination in healthy volunteers. Psychopharmacology Berl 2003; 166(2):102–10.

    CAS  PubMed  Google Scholar 

  46. *Hartmann E. Sleep Research 1979; 8:98.

    Google Scholar 

  47. *Hendrickse WA, Roffwarg HP, Granneman BD et al. The effects of fluoxetine on the polysomnogram of depressed outpatients: a pilot study. Neuropsychopharmacology 1994; 10:85–91

    CAS  PubMed  Google Scholar 

  48. *Jindal RD, Friedman ES, Berman SR et al. Effects of sertraline on sleep architecture in patients with depression. J Clin Psychopharmacol 2003; 23(6):540–8.

    Article  CAS  PubMed  Google Scholar 

  49. *Kupfer DJ, Perel JM, Pollock BG et al. Fluvoxamine versus desipramine: comparative polysomnographic effects. Biological Psychiatry 1991; 29:33–40.

    Article  Google Scholar 

  50. *Nicholson AN, Pascoe PA Studies on the modulation of the sleep-wakefulness continuum in man by fluoxetine, a 5HT uptake inhibitor. Neuropharmacology 1988; 27:597–602.

    Article  CAS  PubMed  Google Scholar 

  51. *Oswald I, Adam K. Effects of paroxetine on human sleep. Br J Clin Pharmacol 1986; 22(1):97–9.

    CAS  PubMed  Google Scholar 

  52. *Roschke J, Kogel P, Schlosser R et al. Analysis of sleep EEG microstructure in subchronic paroxetine treatment of healthy subjects Psychopharmacology (Berl) 1997; 132(1):44–9.

    Article  CAS  PubMed  Google Scholar 

  53. *Saletu B, Frey R, Krupka M et al. Sleep laboratory studies on the single-dose effects of serotonin reuptake inhibitors paroxetine and fluoxetine on human sleep and awakening qualities. Sleep 1991; 14(5):439–47.

    CAS  PubMed  Google Scholar 

  54. *Schlosser R, Roschke J, Rossbach W et al. Conventional and spectral power analysis of all-night sleep EEG after subchronic treatment with paroxetine in healthy male volunteers. Eur Neuropsychopharmacol 1998; 8(4):273–8.

    Article  CAS  PubMed  Google Scholar 

  55. *Sharpley AL, Williamson DJ, Attenburrow ME et al. The effects of paroxetine and nefazodone on sleep: A placebo controlled trial. Psychopharmacology (Berl) 1996; 126(1):50–4.

    Article  CAS  PubMed  Google Scholar 

  56. *Staner L, Kerkhofs M, Detroux D et al. Acute, subchronic and withdrawal sleep EEG changes during treatment with paroxetine and amitriptyline: A double-blind randomized trial in major depression. Sleep 1995; 18(6):470–7.

    CAS  PubMed  Google Scholar 

  57. *Trivedi MH, Rush AJ, Armitage R et al. Effects of fluoxetine on the polysomnogram in outpatients with major depression. Neuropsychopharmacology 1999; 20(5):447–59.

    Article  CAS  PubMed  Google Scholar 

  58. *Winokur A, DeMartinis NA 3rd, McNally DP et al. Comparative effects of mirtazapine and fluoxetine on sleep physiology measures in patients with major depression and insomnia. Clin Psychiatry 2003; 64(10):1224–9.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychopharmacology Unit, University of Bristol, Bristol, UK

    Sue J. Wilson

  2. Psychopharmacology Unit, School of Medical Sciences, University of Bristol, Bristol, UK

    David J. Nutt

Authors
  1. Sue J. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David J. Nutt
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Landes Bioscience/Eurekah.com and Springer Science+Business Media

About this chapter

Cite this chapter

Wilson, S.J., Nutt, D.J. (2006). SSRIs and Sleep in Man. In: Sleep and Sleep Disorders. Springer, Boston, MA. https://doi.org/10.1007/0-387-27682-3_31

Download citation

Publish with us

Policies and ethics

Search

Navigation