Effects of Antipsychotic Treatment on Polysomnographic Measures in Schizophrenia: A Replication and Extension

Maixner, Susan M.; Tandon, Rajiv; Eiser, Alan S.; Taylor, Stephan F.; DeQuardo, John R.; Shipley, James E.

doi:10.1176/ajp.155.11.1600

Cited by 62 publications

(33 citation statements)

References 11 publications

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“…In contrast with the wellknown role of other neurotransmitter systems in sleep physiology, the consequences of specific dopamine manipulations are far from being clearly understood (Pace-Schott and Hobson 2002). However, the results obtained fall in the line with the global improvement in sleep continuity generally described after antipsychotic administration in schizophrenic patients (Stephan et al 1991;Maixner et al 1998). Specifically, patients under haloperidol treatment usually show increases in TST and sleep efficiency but no change, or even a decrease, in the amount of SWS (Itil et al 1970).…”

Section: Discussionsupporting

confidence: 71%

Effects of olanzapine, risperidone and haloperidol on sleep after a single oral morning dose in healthy volunteers

et al. 2007

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Objectives To compare the effects of typical and atypical antipsychotic drugs on sleep activity and subjective sleep quality. Design Randomised, double-blind, placebo-controlled, four-period cross-over, clinical trial was used to evaluate the effects of active treatments on objective and subjective sleep variables. Setting Sleep laboratory evaluation. Participants Twenty healthy young volunteers, both sexes. Interventions Single oral morning administrations of olanzapine 5 mg, risperidone 1 mg, haloperidol 3 mg and placebo. Measurements and results Five polysomnographic nights were evaluated: one control night and one after each intervention. Significant increase in total sleep time, sleep efficiency, slow wave sleep (SWS) and rapid eye movement (REM) sleep with decreases in wake time were observed after olanzapine. Decreases in wake time, REM sleep and stage shifts together with increases in stage 2 were obtained after risperidone. Haloperidol showed only a tendency to increase sleep efficiency and stage 2 and to decrease wake time. Olanzapine showed decreases in power density in frequencies higher than 10 Hz during all sleep stages and in frequencies lower than 5 Hz range in SWS; decreases in the dynamics of spindle frequency activity (SFA) in the second and fourth non-rapid eye movement (NREM) episodes were also obtained. Risperidone presented increases in the 3.6-10.8 Hz frequency range in NREM sleep stages and in stage 2. Haloperidol also showed increases in NREM sleep stages and in stage 2, but these were in frequencies higher than 10 Hz, with increases in the dynamics of SFA in the first NREM episode. Only a significant improvement in subjective sleep quality was observed after olanzapine. Conclusions Antipsychotics showed different sleep changes as their neurochemical profiles were distinct. These changes were observed even when the drug was administered 15 h before going to bed.

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Section: Discussionsupporting

confidence: 71%

Effects of olanzapine, risperidone and haloperidol on sleep after a single oral morning dose in healthy volunteers

et al. 2007

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“…Considering known cholinergic effects on REM latency and other sleep measures Gillin and Sitaram 1984), these data are consistent with the hypothesis of increased cholinergic activity in schizophrenia and its implication in the production of negative symptoms. In related studies (Taylor et al 1991;Maixner et al 1998;Tandon 1997), we observed that polysomnographic measures partially normalized following antipsychotic treatment (with neuroleptics, clozapine, and risperidone). Assuming that increased cholinergic activity partly underlies polysomnographic abnormalities in schizophrenia at drug-free baseline, these data may indicate a trend for increased cholinergic activity to partially normalize with neuroleptic therapy (Figure 1) (Tandon and Greden 1989;Tandon et al 1990a).…”

Section: In Vivo Measurement Of Central Cholinergic Activitymentioning

confidence: 69%

The Cholinergic System in Schizophrenia Reconsidered: Anticholinergic Modulation of Sleep and Symptom Profiles

Tandon

Taylor

DeQuardo

et al. 1999

Neuropsychopharmacology

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Receptors, Cholinergic; Receptors, muscarinic; Parasympathetic nervous system; Sleep, REM; Symptoms, positive; Symptoms, negative The dopamine (DA) hypothesis has dominated biochemical and pharmacological research on schizophrenia for about two decades. Although pharmacological data implicate increased DA activity in the pathogenesis of positive symptoms of schizophrenia, there is minimal association with negative symptoms (Crow 1980;Andreasen and Olsen 1982;Angrist et al. 1980). The poorly elucidated pathogenesis of negative symptoms and the unique properties of the atypical antipsychotic clozapine (Jibson and Tandon 1998) have encouraged a reappraisal of the role of the DA system in schizophrenia. Newer approaches to evaluating neurochemical abnormalities in schizophrenia include consideration of other neurotransmitter systems. Models of DA-serotonin (Meltzer 1989), DA-glutamate (Carlsson and Carlsson 1990), DA-acetylcholine (Tandon and Greden 1989), and DA-norepinephrine (van Kammen et al. 1990) interactions have been proposed. Although these models still accord DA a significant role in schizophrenia pathophysiology, they suggest that altered balance between DA and one (or more) of these other neurotransmitter systems may be the principal neurochemical abnormality related to the production of schizophrenic symptoms. Some of the earliest pharmacological treatments for schizophrenia included cholinergic agents (Cohen et al. 1944;Collard et al. 1946;Pfeiffer and Jenney 1957), and in the 1970s, several investigators suggested that cholinergic activity may be reduced in schizophrenia (Friedhoff and Alpert 1973;Janowsky et al. 1973;Davis et al. 1975;Singh and Kay 1979). There was no direct evidence of altered cholinergic functioning in schizophrenic patients, however, and pharmacological trials with cholinergic agents were generally ineffective (Rowntree et al. 1950;Gerlach et al. 1977;Davis and Berger 1978). With few exceptions (Johnstone et al. 1983;Singh et al. 1987), cholinergic mechanisms were increasingly considered irrelevant to the pathophysiology of schizophrenia and discussed predominantly with reference to the treatment of undesirable extrapyramidal side effects of neuroleptics (Richelson 1984). Indirect evidence from several lines of research, however, suggests that the cholinergic system may differentially influence positive and negative symptoms in schizophrenia (Tandon and Greden 1989).We and others have been conducting various studies to evaluate the role of the cholinergic system in schizophrenia, based on a primary hypothesis that DA-acetylcholine (ACh) interactions are of central importance in the production of positive and negative symptoms of schizophrenia (Tandon and Greden 1989;Tandon and Greden 1991). Based on available data and on observations of the course of positive and negative symptoms during the acute phase of the illness (Donlon and Blacker 1973;Docherty et al. 1978;Tandon et al. 1990a), we posited a role for disruption in DA-ACh balance in the expression of positive and negat...

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“…As a general rule, first-generation APs improve sleep maintenance, increasing TST and SE and reducing SL and waking after sleep onset, although their effects on REML, REM time, and REM EM density differ [56][57][58][59][60][61]. Chlorpromazine increases SWS time, an effect consistent with a related increase in REML [56].…”

Section: Antipsychotics: Effects On Sleep Patternsmentioning

confidence: 87%

Sleep in Schizophrenia: Impairments, Correlates, and Treatment

Benson¹

2006

Psychiatric Clinics of North America

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Effects of Antipsychotic Treatment on Polysomnographic Measures in Schizophrenia: A Replication and Extension

Cited by 62 publications

References 11 publications

Effects of olanzapine, risperidone and haloperidol on sleep after a single oral morning dose in healthy volunteers

Effects of olanzapine, risperidone and haloperidol on sleep after a single oral morning dose in healthy volunteers

The Cholinergic System in Schizophrenia Reconsidered: Anticholinergic Modulation of Sleep and Symptom Profiles

Sleep in Schizophrenia: Impairments, Correlates, and Treatment

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