Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-15T17:45:50.513Z Has data issue: false hasContentIssue false
  • English
  • Français

Circadian Rhythm Sleep Disorders as a Possible Side Effect of Fluvoxamine

Published online by Cambridge University Press:  07 November 2014

Haggai Hermesh ,
Hadas Lemberg ,
Judith Abadi  and
Yaron Dagan
Get access Rights & Permissions [Opens in a new window]

Abstract

Sleep problems, day somnolence, and fatigue as a result of psychotropic drugs are very common. Psychiatrists usually consider these effects a result of insomnia and treat them by prescribing sleeping pills or other benzodiazepine agents.

We describe here 10 cases of circadian rhythm sleep disorders (CRSD)—and not merely insomnia—as a possible side effect of fluvoxamine (FVA). Two other serotonin reuptake inhibitors, fluoxetine and clomipramine, did not induce CRSD in any of these 10 patients. We speculate that FVA-induced CRSD is caused by the effect of FVA on serotonin and melatonin levels in the central nervous system.

CRSD as a side effect of FVA can be treated by replacing the suspected FVA or adding melatonin to a beneficial FVA treatment. Thus, it is important to be aware of possible iatrogenic CRSD in order to treat appropriately. Prospective studies are needed to confirm our observation and to study the influence of other psychotropic drugs on sleep-wake schedule.

Type
Original Research
Information
CNS Spectrums , Volume 6 , Issue 6: Medical Chronobiology in Psychiatry and Neurology , June 2001 , pp. 511 - 513
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. Rochester, MN: American Sleep Disorders Association; 1997.Google Scholar
2.Sadeh, A, Aesler, DU, Lawre, P. Actigraphically-based automatic bedtime sleep-wake recording: validity and clinical applications. Journal of Ambulatory Monitoring. 1989;2:209–216.Google Scholar
3.Kelsey, JE, Nemeroff, BN. Selective serotonin reuptake inhibitors. In: Sadock, BJ, Sadock, VA, eds. Comprehensive Textbook of Psychiatry. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000:2432–2455.Google Scholar
4.Bezchlibnyk-Butler, KZ, Jeffries, JJ. Selective serotonin-reuptake inhibitors (SSRIs). In: Bezchlibnyk-Buder, KZ, Jeffries, JJ, eds. Clinical Handbook of Psychotropic Drugs. 5th ed. Seattle, WA: Hogrefe & Huber; 1995.Google Scholar
5.Arendt, J. Melatonin and the Mammalian Pineal Gland. London, England: Chapman & Hall; 1995.Google Scholar
6.Monteleone, P, Orazzo, C, Natale, M, Maj, M. Lack of effect of short-term fluoxetine administration on nighttime plasma melatonin levels in healthy subjects. Biol Psychiatry. 1994;35:39–42.CrossRefGoogle ScholarPubMed
7.Demisch, K, Demisch, L, Bochnik, HJ, et al.Melatonin and cortisol increase after fluvoxamine. Br J Clin Pharmacol. 1986;22:620–622.CrossRefGoogle ScholarPubMed
8.Demisch, K, Demisch, L, Nickelsen, T, Rieth, R. The influence of acute and subchronic administration of various antidepressants on early morning melatonin plasma levels in healthy subjects: increases following fluvoxamine. J Neural Transm. 1987;68:257–270.CrossRefGoogle ScholarPubMed
9.Grozinger, M, Hartter, S, Wang, X, et al.Fluvoxamine strongly inhibits melatonin metabolism in a patient with low-amplitude melatonin profile. Arch Gen Psychiatry. 2000;57:812–813.CrossRefGoogle Scholar
10.von Bahr, C, Ursing, C, Yasui, N, et al.Fluvoxamine but not citalopram increases serum melatonin in healthy subjects: an indication that cytochrome P450 CYP1A2 and CYP2C19 hydroxylate melatonin. Eur J Clin Pharmacol. 2000;56:123–127.CrossRefGoogle Scholar
11.Silver, H, Barash, I, Odnopozov, N, Jahjah, N, Mizruhin, A. Melatonin secretion during fluvoxamine treatment in medicated chronic schizophrenic patients: evidence for the development of tolerance to selective serotonin re-uptake inhibitor. Biol Psychiatry. 1996;1:75–77.CrossRefGoogle Scholar
12.Wirz-Justice, A, Cajochen, C, Nussbaum, P. A schizophrenic patient with an arrhythmic circadian rest-activity cycle. Psychiatry Res. 1997;73:83–90.CrossRefGoogle ScholarPubMed
13.Goodman, WK, Price, LH, Ramussen, SA, et al.The Yale-Brown obsessive-compulsive scale (Y-BOCS): part 1: development, use, and reliability. Arch Gen Psychiatry. 1989;46:1006–1011.CrossRefGoogle Scholar
14.Den Boer, JA, Westenberg, HG. Serotonin function in panic disorder: a double-blind placebo-controlled study with fluvoxamine and ritanserin. Psychopharmacology (Berl). 1990;102:85–94.CrossRefGoogle ScholarPubMed
15.Skene, DJ, Bojkowski, CJ, Arendt, J. Comparison of the effects of acute fluvoxamine and desipramine administration on melatonin and cortisol production in humans. Br J Clin Pharmacol. 1994;37:181–186.CrossRefGoogle ScholarPubMed
16.Childs, PA, Rodin, I, Martin, NJ, et al.Effect of fiuoxetine on melatonin in patients with seasonal affective disorder and matched controls. Br J Psychiatry. 1995;166:196–1988.CrossRefGoogle ScholarPubMed