• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Sleepwalking on Antipsychotics and Lithium

Sleepwalking on Antipsychotics and Lithium

November 5, 2021
Thomas Jordan, MD.
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Thomas Jordan, MD. Dr. Jordan has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

REVIEW OF: Gouverneur A et al, Br J Clin Pharmacol 2021;87:3971–3977


STUDY TYPE: Retrospective analysis


Sleepwalking and sleep-eating are common parasomnias, also known as somnambulism and sleep-related eating disorder. Both can be side effects of benzos, z-hypnotics, and—rarely—antidepressants. This review looked at parasomnias’ association with antipsychotics and lithium.


The authors used a World Health Organization database of suspected adverse drug reactions, which contains reports by physicians dating back to 1978. Lacking a control group, they compared the rate of parasomnias in the database with that in the general population to see if there was any disproportional reporting for patients on atypical antipsychotics or lithium.


They presented their data in terms of the proportional reporting ratio (PRR) for each medication—where a PRR over 1 means the parasomnia might be associated with the medication. As expected, the highest PRR by far was for the benzodiazepines and z-drugs, together at 60.51. The PRRs were also elevated for the atypical antipsychotics at 3.44 (CI 3.13–3.78) and lithium at 2.03 (CI 1.22–3.37). First-generation antipsychotics did not show a significant PRR at 0.99 (0.68–1.44), while antidepressants clocked in at 3.01 (CI 2.76–3.28). Atypical antipsychotics with the highest PRRs were quetiapine at 12.50 (CI 11.06–14.13), lurasidone at 7.00 (CI 3.97–12.34), olanzapine at 3.23 (CI 2.50–4.17), and aripiprazole at 2.89 (CI 2.17–3.83). Of the atypical antipsychotics, nearly all had a significant PRR except for risperidone, paliperidone, and clozapine.


The main weakness here is that data of this type are meant to find associations but cannot confirm them. Also, the results do not tell us how common the problem is, as mild cases are usually not reported to these kinds of databases.


TCPR’S Take
Although benzodiazepines and z-hypnotics are the medications that are most likely to cause parasomnias, these sleep problems may also occur on antidepressants, lithium, and most atypical antipsychotics.

General Psychiatry
KEYWORDS antipsychotics lithium second-generation-antipsychotics-sgas side-effects sleep sleep_disorders somnambulism
Thomas Jordan, MD.

Does Baclofen Titrated to High Doses Reduce Alcohol Use?

More from this author
www.thecarlatreport.com
Issue Date: November 5, 2021
SUBSCRIBE NOW
Table Of Contents
How to Treat ADHD in Bipolar Disorder
In the News: Aducanumab (Aduhelm)
Viloxazine for ADHD
Listening to Depression: The Importance of Addressing Hearing Loss
Establishing a Dose-Response Relationship for Lurasidone in Acute Schizophrenia
Sleepwalking on Antipsychotics and Lithium
In Brief: Meds in the Fast Lane
How to Diagnose Bipolar Disorder
Nutritional Psychiatry in Practice
CME Post-Test - Bipolar Disorder, TCPR, November/December 2021
DOWNLOAD NOW
Featured Book
  • MFB6eCover.jpg

    Medication Fact Book for Psychiatric Practice, Sixth Edition (2022)

    Guidance, clinical pearls, and bottom-line assessments covering the medications you use in your...
    READ MORE
Featured Video
  • therapist_canstockphoto9201097.jpg
    General Psychiatry

    Using SAMe In Clinical Practice with Garrett Rossi, MD

    Read More
Featured Podcast
  • canstockphoto4921771.jpg
    General Psychiatry

    Psychopharm Commandment #6: MAOIs

    MAOIs rank high in efficacy and are pretty well tolerated too, as long as you watch for two critical interactions.

    Listen now
Recommended
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png

About

  • About Us
  • CME Center
  • FAQ
  • Contact Us

Shop Online

  • Newsletters
  • Multimedia Subscriptions
  • Books
  • eBooks
  • ABPN Self-Assessment Courses

Newsletters

  • The Carlat Psychiatry Report
  • The Carlat Child Psychiatry Report
  • The Carlat Addiction Treatment Report
  • The Carlat Hospital Psychiatry Report
  • The Carlat Geriatric Psychiatry Report

Contact

info@thecarlatreport.com

866-348-9279

PO Box 626, Newburyport MA 01950

Follow Us

Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

© 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.