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Sleep in Schizophrenia Patients and the Effects of Second Generation Antipsychotic Drugs

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Dopamine and Sleep

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Abstract

Insomnia is a common feature in schizophrenia, and is characterized by an increase of sleep onset latency (SOL), and a reduction of total sleep time (TST), sleep efficiency (SE), and rapid-eye-movement (REM) sleep latency, but REM sleep percentage remain unchanged. According to polysomnographic studies, the administration of clozapine, olanzapine and paliperidone to schizophrenia patients was followed by a significant reduction of SL and an increase of TST and stage S2. In addition, olanzapine and paliperidone augmented SE, slow wave sleep (SWS) and REM sleep. In contrast, quetiapine administration further disrupted sleep as judged by an increase of SOL, wake time after sleep onset (WASO) and REM sleep latency, and a reduction of SWS and REM sleep. With respect to risperidone, available information tends to indicate that the compound increases SWS. To date, no polysomnographic studies have been published on the effects of ziprasidone, aripiprazole, asenapine, iloperidone and lurasidone on sleep in schizophrenia patients. Somnolence is a common side-effect in patients receiving clozapine, olanzapine, asenapine and iloperidone, followed by ziprasidone and quetiapine. In contrast, insomnia is frequently reported by patients taking aripiprazole and lurasidone.

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References

  • Abi-Dargham A, Rodenhiser J, Printz D, Zea-Ponce Y, Gil R, Kegeles LS et al (2000) Increased baseline occupancy of D2 receptors by dopamine in schizophrenia. Proc Natl Acad Sci USA 97:8104–8109

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • American Academy of Sleep Medicine (2005) International classification of sleep disorders: diagnostic and coding manual second edition (ICSD-2). Darian, IL

    Google Scholar 

  • American Academy of Sleep Medicine (2014) International classification of sleep disorders: diagnostic and coding manual, third edition (ICSD-3). Darian, IL

    Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. Arlington, VA

    Book  Google Scholar 

  • Arnt J, Skarsfeldt T (1998) Do novel antipsychotics have similar pharmacological characteristics? A review of the evidence. Neuropsychopharmacology 18:63–101

    Article  CAS  PubMed  Google Scholar 

  • Baldessarini RJ, Tarazi RI (2001) Drugs and the treatment of psychiatric disorders. In: JG Hardman, LE Limbird (eds) The pharmacological basis of therapeutics. McGraw Hill, New York, Chapter 20, pp 485–520

    Google Scholar 

  • Berridge CW, Schmeichel BE, España RA (2012) Noradrenergic modulation of wakefulness/arousal. Sleep Med Rev 16:187–197

    Article  PubMed  PubMed Central  Google Scholar 

  • Callaghan JT, Bergstrom RF, Ptak LR, Beasley CM (1999) Olanzapine: pharmacokinetic and pharmacodynamic profile. Clin Pharmacokinet 37:177–193

    Article  CAS  PubMed  Google Scholar 

  • Carlsson A, Lindqvist M (1963) Effect of chlorpromazine or haloperidol on formation of 3-methoxytyamine and normetanephrine in mouse brain. Acta Pharmacol Toxicol 20:140–144

    Article  CAS  Google Scholar 

  • Citrome L (2012) A systematic review of meta-analysis of the efficacy of oral atypical antipsychotics for the treatment of adult patients with schizophrenia. Expert Opin Pharmacother 13:1545–1573

    Article  CAS  PubMed  Google Scholar 

  • DeVane CL, Nemeroff CB (2001) Clinical pharmacokinetics of quetiapine; an atypical antipsychotic. Clin Pharmacokinet 40:509–522

    Article  CAS  PubMed  Google Scholar 

  • Dolder C, Nelson M, Deyo Z (2008) Paliperidone for schizophrenia. Am J Health Syst Pharm 65:403–413

    Article  CAS  PubMed  Google Scholar 

  • Eggers AE (2013) A serotonin hypothesis of schizophrenia. Med Hypotheses 80:791–794

    Article  CAS  PubMed  Google Scholar 

  • FrÃ¥nberg O, Wiker C, Marcus MM, Konradsson A, Jardemark K, Schilström B et al (2008) Asenapine, a novel psychopharmacologic agent: preclinical evidence for clinical effects in schizophrenia. Psychopharmacology 196:417–429

    Article  PubMed  Google Scholar 

  • Frangou S, Murray RM (1996) Imaging as a tool in exploring the neurodevelopmental and genetics of schizophrenia. Br Med Bull 52:587–596

    Article  CAS  PubMed  Google Scholar 

  • Gao K, Mackle M, Cazorla P, Zhao J, Szegedi A (2013) Comparison of somnolence associated with asenapine, olanzapine, risperidone, and haloperidol relative to placebo in patients with schizophrenia or bipolar disorder. Neuropsychiatr Dis Treat 9:1145–1157

    CAS  PubMed  PubMed Central  Google Scholar 

  • Heykants J, Huang ML, Mannens G, Meuldermans W, Snoeck E, Van Beijsterveldt L et al (1994) The pharmacokinetics of risperidone in humans: a summary. J Clin Psychiatry 55(Suppl):13–17

    PubMed  Google Scholar 

  • Hinze-Selch D, Mullington J, Orth A, Lauer CJ, Pollmächer T (1997) Effects of clozapine on sleep. A longitudinal study. Biol Psychiatry 42:260–266

    Article  CAS  PubMed  Google Scholar 

  • Hoffman RE, Boutros NN, Hu S, Berman RM, Krystal JH, Charney DS (2000) Transcranial magnetic stimulation and auditory hallucinations in schizophrenia. Lancet 355:1073–1075

    Article  CAS  PubMed  Google Scholar 

  • Horacek J, Bubenikova-Valesova V, Kopecek M, Palenicek T, Dockery C, Mohr P et al (2006) Mechanism of action of atypical antipsychotic drugs and the neurobiology of schizophrenia. CNS Drugs 20:389–409

    Article  CAS  PubMed  Google Scholar 

  • Howes OD, Shotbolt P, Bloomfield M, Daalman K, Demjaha A, Diederen KM et al (2013) Dopaminergic function in the psychosis spectrum: an [18F]-Dopa imaging study in healthy individuals with auditory hallucinations. Schizophr Bull 39:807–814

    Article  PubMed  Google Scholar 

  • Iber C, Ancoli-Israel S, Chesson A, Quan SF (eds) (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specification, 1st edn. Westchester, IL

    Google Scholar 

  • Janicak PG, Winans EA (2007) Paliperidone ER: a review of the clinical trial data. Neuropsychiatr Dis Treat 3:869–883

    CAS  PubMed  PubMed Central  Google Scholar 

  • Jarskog LF, Miyamoto S, Lieberman JA (2007) Schizophrenia: new pathological insights and therapies. Annu Rev Med 58:49–61

    Article  CAS  PubMed  Google Scholar 

  • Jentsch JD, Redmond DE, Elsworth JD, Taylor JR, Youngren KD, Roth RH (1997) Enduring cognitive deficits and cortical dopamine dysfunction in monkeys after long-term administration of phencyclidine. Science 277:953–955

    Article  CAS  PubMed  Google Scholar 

  • Kemali D, Galderisi S, Maj M, Mucci A, Di Gregorio M, Bucci P (1992) Computerized EEG topography findings in schizophrenic patients before and after haloperidol treatment. Int J Psychophysiol 13:283–290

    Article  CAS  PubMed  Google Scholar 

  • Keshavan MS, Prasad KM, Montrose DM, Miewald JM, Kupfer DJ (2007) Sleep quality and architecture in quetiapine, risperidone, or never-treated schizophrenia patients. J Clin Psychopharmacol 27:703–705

    Article  CAS  PubMed  Google Scholar 

  • Kluge M, Schacht A, Himmerich H, Rummel-Kluge C, Wehmeir PM, Dalal M et al (2014) Olanzapine and clozapine differently affect sleep in patients with schizophrenia: Results from a double-blind, polysomnographic study and review of the literature. Schizophrenia Res 152:255–260

    Article  Google Scholar 

  • Krystal JH, Karper LP, Seibyl JP, Freeman GK, Delaney R, Heninger GR et al (1994) Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans. Psychotomimetic, perceptual, cognitive, and neuroendocrine responses. Arch Gen Psychiatry 51:199–214

    Article  CAS  PubMed  Google Scholar 

  • Lee JH, Woo JI, Meltzer HY (2001) Effects of clozapine on sleep measures and sleep-associated changes in growth hormone and cortisol in patients with schizophrenia. Psychiatry Res 103:157–166

    Article  CAS  PubMed  Google Scholar 

  • Leucht S, Cipriani A, Spineli L, Mavridis D, Orey D, Richter F et al (2013) Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet 382:951–962

    Article  CAS  PubMed  Google Scholar 

  • Lichstein KL, Gellis LA, Stone KC, Nau SD (2006) Primary and secondary insomnia. In: Pandi-Perumal SR, Monti JM (eds) Clinical pharmacology of sleep. Birkhäuser Verlag, Basel, pp 1–9

    Chapter  Google Scholar 

  • Lieberman JA, Bymaster FP, Meltzer HY, Deutch AY, Duncan GE, Marx C et al (2008) Antipsychotic drugs: comparison in animal models of efficacy, neurotransmitter regulation, and neuroprotection. Pharmacol Rev 60:358–403

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Loebel AD, Siu CO, Cucchiaro JB, Pikalov AA, Harvey PD (2014) Daytime sleepiness associated with lurasidone and quetiapine XR: results from a randomized double-blind, placebo-controlled trial in patients with schizophrenia. CNS Spectr 19:197–205

    Article  PubMed  Google Scholar 

  • Luthringer R, Staner L, Noel N, Muzet M, Gassmann-Mayer C, Talluir K et al (2007) A double-blind, placebo-controlled, randomized study evaluating the effect of paliperidone extended-release tablets on sleep architecture in patients with schizophrenia. Int Clin Psychopharmacol 22:299–308

    Article  PubMed  Google Scholar 

  • Meltzer HY (1997) Treatment-resistant schizophrenia—the role of clozapine. Curr Med Res Opin 14:1–20

    Article  CAS  PubMed  Google Scholar 

  • Monti JM (2011a) The role of tuberomammillary nucleus histaminergic neurons, and of their receptors, in the regulation of sleep and waking. In: Mallick BN, Pandi-Perumal SR, McCarley RW, Morrison AR (eds) REM sleep: regulation and function. Cambridge University Press, Cambridge, pp 223–233

    Google Scholar 

  • Monti JM (2011b) Serotonin 5-HT2A receptor antagonists in the treatment of insomnia: present status and future prospects. Drugs Today 46:183–193

    Article  Google Scholar 

  • Monti JM (2013) The neurotransmitters of sleep and wake, a physiological reviews series. Sleep Med Rev 17:313–315

    Article  PubMed  Google Scholar 

  • Monti JM, Monti D (2005) Sleep disturbances in schizophrenia. Int Rev Psychiatry 17:247–253

    Article  PubMed  Google Scholar 

  • Monti JM, Jantos H (2008) The roles of dopamine and serotonin, and of their receptors, in regulating sleep and wakefulness. Progr Brain Res 172:625–646

    Article  CAS  Google Scholar 

  • Moser D, Anderer P, Gruber G, Parapatics S, Loretz E, Boeck M et al (2009) Sleep classification according to AASM and Rechtschaffen & Kales: effects on sleep scoring parameters. Sleep 32:139–149

    PubMed  PubMed Central  Google Scholar 

  • Müller MJ, Rossbach W, Mann K, Roschke J, Müller-Siecheneder F, Blümler M et al (2004) Subchronic effect of olanzapine on sleep EEG in schizophrenic patients with predominantly negative symptoms. Pharmacopsychiatry 37:157–162

    Article  PubMed  Google Scholar 

  • Muralidharan K, Ali M, Silveira LE, Bond DJ, Fountoulakis KN, Lam RW et al (2013) Efficacy of second generation antipsychotics in treating acute mixed episodes in bipolar disorder: a meta-analysis of placebo-controlled trials. J Affect Disord 150:408–419

    Google Scholar 

  • Poulin J, Stip E, Godbout R (2008) REM sleep EEG spectral analysis in patients with first-episode schizophrenia. J Psychiatr Res 42:1086–1093

    Article  PubMed  Google Scholar 

  • Rechtschaffen A, Kales A (1968) A manual of standardized terminology, techniques and scoring system for sleep stages in human subjects. National Institute of Health Publ 204. Washington DC Government Printing Office

    Google Scholar 

  • Reynolds CF, O’Hara R (2013) DSM-5 sleep-wake disorders classification: overview for use in clinical practice. Am J Psychiatry 170:1099–1101

    Article  PubMed  Google Scholar 

  • Salin-Pascual RJ, Herrera-Estrella M, Galicia-Polo L, Laurrabaquio MR (1999) Olanzapine acute administration in schizophrenic patients increases delta sleep and sleep efficiency. Biol Psychiatry 46:141–143

    Article  CAS  PubMed  Google Scholar 

  • Salin-Pascual RJ, Herrera-Estrella M, Galicia-Polo L, Rosas M, Brunner E (2004) Low delta sleep predicted a good clinical response to olanzapine administration in schizophrenic patients. Rev Invest Clin 56:345–350

    CAS  PubMed  Google Scholar 

  • Sateia MJ (2009) Identification and management of insomnia. Chest 135:1370–1379

    Article  PubMed  Google Scholar 

  • Sekimoto M, Kato M, Watanabe T, Kajimura N, Takahashi K (2007) Reduced frontal asymmetry of delta waves during all-night sleep in schizophrenia. Schizophr Bull 33:1307–1311

    Article  PubMed  Google Scholar 

  • Shin JK, Malone DT, Crosby IT, Capuano B (2011) Schizophrenia: a systematic review of the disease state, current therapeutics and their molecular mechanisms of action. Curr Med Chem 18:1380–1404

    Article  CAS  PubMed  Google Scholar 

  • Staner L, Noël N, Luthringer R (2008) Schizophrenia, sleep, and antipsychotic drugs. In: Pandi-Perumal SR, Verster JC, Monti JM, Lader M, Langer SZ (eds) Sleep disorders—diagnosis and therapeutics. Informa Healthcare, London, pp 417–426

    Chapter  Google Scholar 

  • Tandon R (1997) Effects of atypical antipsychotics on polysomnographic measures in schizophrenia. In: Judd LL, Saletu B, Filip B (eds) Basic and clinical science of mental and addictive disorders. Bibl Psychiat, Basel, pp 219–222

    Chapter  Google Scholar 

  • Tekell JL, Hoffmann R, Hendrickse W, Greene RW, Rush AJ, Armitage R (2005) High frequency EEG activity during sleep: characteristics in schizophrenia and depression. Clin EEG Neurosci 36:25–35

    Article  PubMed  Google Scholar 

  • Üçok A, Saka MC, Bilici M (2015) Effects of paliperidone extended release on functioning level and symptoms of patients with recent onset schizophrenia: an open-label, single-arm, flexible dose, 12-months follow-up study. Nord J Psychiatry 69:426–432

    Article  PubMed  Google Scholar 

  • Vermeir M, Naessens I, Remmerie B, Mannens G, Hendricks J, Sterkens P et al (2008) Absorption, metabolism, and excretion of paliperidone, a new monoaminergic antagonist, in humans. Drug Metab Dispos 36:769–779

    Article  CAS  PubMed  Google Scholar 

  • Wetter TC, Lauer CJ, Gillich G, Pollmächer T (1996) The electroencephalographic sleep patterns in schizophrenic patients treated with clozapine or classical antipsychotic drugs. J Psychiatr Res 30:411–419

    Article  CAS  PubMed  Google Scholar 

  • Wine JN, Sanda C, Caballero J (2009) Effects of quetiapine on sleep in nonpsychiatric and psychiatric conditions. Ann Pharmacother 43:707–713

    Article  CAS  PubMed  Google Scholar 

  • Winokur A, Kamath J (2008) The effect of typical and atypical antipsychotic drugs on sleep of schizophrenic patients. In: Monti JM, Pandi-Perumal SR, Jacobs BL, Nutt DJ (eds) Serotonin and sleep: molecular, functional and clinical aspects. Birkhäuser Verlag, Basel, pp 587–610

    Chapter  Google Scholar 

  • Yamashita H, Morinobu S, Yamawaki S, Horiguchi J, Masatsugu N (2002) Effect of risperidone on sleep in schizophrenia: a comparison with haloperidol. Psychiatry Res 109:137–142

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pharmacology and Therapeutics, School of Medicine Clinics Hospital, Montevideo, Uruguay

    Jaime M. Monti

  2. Department of Physiology, School of Medicine, Montevideo, Uruguay

    Pablo Torterolo

  3. Somnogen Canada Inc., College Street, Toronto, Ontario, Canada

    Seithikurippu R. Pandi Perumal

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  1. Jaime M. Monti
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  2. Pablo Torterolo
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  3. Seithikurippu R. Pandi Perumal
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Correspondence to Jaime M. Monti .

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Editors and Affiliations

  1. Department of Pharmacology and Therapeutics, School of Medicine, Montevideo, Uruguay

    Jaime M. Monti

  2. Somnogen Canada Inc., Toronto, Ontario, Canada

    S. R. Pandi-Perumal

  3. Department of Neurology, New Jersey Neuroscience Institute, Edison, New Jersey, USA

    S. Chokroverty

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Monti, J.M., Torterolo, P., Pandi Perumal, S.R. (2016). Sleep in Schizophrenia Patients and the Effects of Second Generation Antipsychotic Drugs. In: Monti, J., Pandi-Perumal, S., Chokroverty, S. (eds) Dopamine and Sleep. Springer, Cham. https://doi.org/10.1007/978-3-319-46437-4_10

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