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Rapid-Eye-Movement Sleep Behavior Disorder pp 123–134Cite as

RBD, Antidepressant Medications, and Psychiatric Disorders

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Abstract

Idiopathic RBD (iRBD), co-morbid psychiatric illnesses, and the use of psychotropics have been increasingly reported in the literature. Among the iRBD patients, depression was found to be a common co-morbid condition. Cohorts of iRBD patients reported that those taking antidepressants were associated with significant abnormalities of early neurodegenerative markers. In a Chinese cohort, depression was found to have an increased risk of conversion to Parkinson’s disease. On the other hand, RBD symptoms have been reported in patients with psychiatric illnesses (pRBD), such as depression and post-traumatic stress disorders. This pRBD group of subjects was mostly of younger age, a higher prevalence of female gender, albeit they had a similar degree of sleep-related injuries to that of typical iRBD. While the previous literature used to regard it as an iatrogenic condition induced by antidepressants, more evidence from case-control studies, cohort studies and neuroimaging results suggested that it could be a complex condition. Apart from the drug effect, it is likely that the psychiatric illnesses per se, with a possibility of underlying neurodegeneration, could contribute to the development of RBD symptoms. Further study will need to determine the outcome of pRBD, their underlying neural circuitry, and neurotransmitter abnormalities.

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Note Added in Proof:

The following are five recent pertinent publications: (1) Okuda M, Iwamoto K, Miyata S, Torii Y, Iritani S, Ozaki N. Early diagnosis of Lewy body disease in patients with late-onset psychiatric disorders using clinical history of REM sleep behavior disorder and 123 I-MIBG cardiac scintigraphy. Psychiatry Clin Neurosci 2018; doi: 10.1111/pcn.12651. (2) Fujishiro H, Okuda M, Iwamoto K, et al. REM sleep without atonia in middle-aged and older psychiatric patients and Lewy body disease: a case series. Int J Geriatr Psychiatry 2017;32:397–406. (3) Tan L, Zhou J, Yang L, Ren R, Zhang Y, Li T, Tang X. Duloxetine-induced rapid eye movement sleep behavior disorder: a case report. BMC Psychiatry 2017;17:372; doi: 10.1186/s12888-017-1535-4. (4) Ryan Williams R, Sandigo G. Venlafaxine-induced REM sleep behavioral disorder presenting as two fractures. Trauma Case Rep 2017;11:18–19. (5) Lee HG, Choi JW, Lee YJ, Jeong DU. Depressed REM sleep behavior disorder patients are less likely to recall enacted dreams than non-depressed ones. Psychiatry Investig 2016;13(2):227–31.

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Authors and Affiliations

  1. Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China

    Siu Ping Lam, Jihui Zhang & Yun Kwok Wing

  2. Department of Psychology, The University of Hong Kong, Hong Kong SAR, China

    Shirley Xin Li

  3. The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China

    Shirley Xin Li

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  1. Siu Ping Lam
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  2. Jihui Zhang
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  3. Shirley Xin Li
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  4. Yun Kwok Wing
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Corresponding author

Correspondence to Yun Kwok Wing .

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Editors and Affiliations

  1. Minnesota Regional Sleep Disorders Center, Departments of Psychiatry, University of Minnesota Medical School and Hennepin County Medical Center, Minneapolis, MN, USA

    Carlos H. Schenck

  2. Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    Birgit Högl

  3. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Aleksandar Videnovic

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Lam, S.P., Zhang, J., Li, S.X., Wing, Y.K. (2019). RBD, Antidepressant Medications, and Psychiatric Disorders. In: Schenck, C., Högl, B., Videnovic, A. (eds) Rapid-Eye-Movement Sleep Behavior Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-90152-7_10

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  • DOI: https://doi.org/10.1007/978-3-319-90152-7_10

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-90152-7

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