Is monoamine oxidase inhibitor induced myoclonus serotoninergically mediated?

Askenasy, J. J. M.; Yahr, Melvin D.

doi:10.1007/bf01244633

Cited by 21 publications

(7 citation statements)

References 41 publications

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“…As noted, myoclonus has not been consistently defined in the literature. In several studies in which an association was made behveen antidepressants and myoclonus, PSG was used to define objectively the leg movements (Noble and Matthew 1969;Lippmann et al 1977;Garvey and Tollefson 1987;Askenasy and Yahr 1988). Yet, periodicity and frequency criteria were not used or were very different from one another (Guilleminault et al 1975;Ware 1983;Myers et al 1986).…”

Section: Discussionmentioning

confidence: 99%

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Fluoxetine-Induced Sleep Disturbance in Depressed Patients

Dorsey

1996

Neuropsychopharmacology

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Abnormal polysomnographic (PSG) features, most notably increased electromyographic (EMG) tone and eye movements during non-REM sleep have been observed during sleep in fluoxetine-treated depressed patients. However, the relationship between these PSG features and sleep disruption is unclear. Nine depressed patients treated with 10 to 80 mg of fluoxetine and six unmedicated, depressed patients were studied polysomnographically on two consecutive nights during which sleep parameters, transient arousals, and eye movements were measured. The fluoxetine group experienced a lower-average sleep efficiency index (SEI) and significantly more eye movements and arousals during non-REM sleep than the control group. Eye movement and arousal counts were significantly correlated. In addition, clinically significant periodic limb movement disorder (PLMD) was observed in 44% of the fluoxetine-treated group versus none of the control group. We conclude that a higher incidence of PLMD and frequent transient arousals associated with eye movements may be responsible in part for the complaint of insomnia made by patients treated with fluoxetine.

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Section: Discussionmentioning

confidence: 99%

“…In studies in which PSG monitoring was employed to document nocturnal myoclonus, periodicity and frequency criteria are either not specified or very different from one another (Guilleminault et al 1975;Ware 1983;Myers et al 1986;Askenasy and Yahr 1988;Forst! and Pohlmann-Eden 1990).…”

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confidence: 99%

Fluoxetine-Induced Sleep Disturbance in Depressed Patients

Dorsey

1996

Neuropsychopharmacology

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“…The difference may possibly be explained by the different dosages administered in previous studies versus our study. Previous studies reported on depressed patients who were treated with high doses of antidepressants [3, 10, 12, 21, 26]. In our study, we treated insomniac patients with doxepin in low doses.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies described an association between the use of tricyclic antidepressants and nocturnal myoclonus (a term formerly used for PLMS [7]) [5, 7, 11, 17]. However, only a few of these studies employed polysomnography [3, 10, 12, 21, 27]. Furthermore, the definition and scoring criteria of leg movements were either not specified or differed largely from one another as the studies were conducted before broadly accepted definition and scoring criteria of PLMS had been developed [1].…”

Section: Introductionmentioning

confidence: 99%

Influence of Low-Dose Doxepin on Periodic Leg Movements in Sleep in Primary Insomnia Patients. Einfluss von niedrig-dosiertem Doxepin auf die periodischen Beinbewegungen im Schlaf bei Patienten mit primarer Insomnie

et al. 2005

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Question of the study As sedating antidepressants have been used increasingly in the treatment of insomnia, the question whether they elicit periodic leg movements in sleep (PLMS) and thereby disturb sleep patterns may be clinically relevant. PLMS are generally supposed to play a role in eliciting and maintaining sleep disturbances in patients with otherwise unexplained insomnia or daytime sleepiness. We evaluated the PLMS data from a double-blind, placebo-controlled polysomnographic treatment study with doxepin in patients with primary insomnia. The aim of the study was to investigate the influence of low-dose doxepin on PLMS. Patients and methods PLMS recordings from the first diagnostic nights were scored in all 40 patients. PLMS scores from each of the 10 polysomnographic (PSG) nights were however available only in a subset of subjects, because PLMS data were originally not considered as a study objective. The PLMS data of 13 patients over 10 nights (2 baseline nights, 3 treatment nights, 3 withdrawal nights, 2 follow-up nights) were assessed. Patients were treated either with doxepin (six patients 50 mg, one patient 25 mg) or with placebo (six patients) 1 h prior to bed time. Results Comparing the doxepin and the placebo group for the different days of the study, we found no significant differences in PLMS parameters. In the doxepin group, the discontinuation of doxepin was however associated with a significant (P < 0.05) decrease in the PLMS-arousal index (PLMS associated with arousal per hour of sleep), indicating a possible relationship between doxepin medication and the presence of PLMS. Conclusions Treatment with low-dose doxepin appears to exert only a weak influence on PLMS in patients with primary insomnia. Keywords sleep -periodic leg movement -tricyclic antidepressant -treatment -primary insomnia ZusammenfassungFragestellung Sedierende Antidepressiva werden zunehmend in der Behandlung der Insomnien eingesetzt. Die Frage, ob sedierende Antidepressiva die Anzahl der PLMS erhöhen gewinnt daher an klinischer Relevanz, da PLMS zur Entstehung bzw. Aufrechterhaltung von Insomnien beitragen können. In der vorliegenden Untersuchung haben wir die PLMS-Daten einer bereits publizierten doppel-blinden plazebo-kontrollierten polysomnographischen (PSG) Behandlungsstudie mit niedrig-dosiertem Doxepin bei Patienten mit primärer Insomnie ausgewertet. Ziel der retrospektiven Auswertung war es, den Einfluss von niedrig-dosiertem Doxepin auf die Anzahl der PLMS zu untersuchen.

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“…This study reports a complete absence of tremor during REM sleep contrasting with the significant increase of EMG isolated motor muscle potentials. "0 12 13 22 29 While Parkinsonian tremor parallels the EMG events during the non-REM sleep, dissociation appears during REM sleep with the disappearance of tremor. It seems that the isolated motor muscle potentials escape to the strong postsynaptic i I IIIlippillilimilillilil 11III _job o , I A , -A&&&A.&-, -T ow -1 --rfv"w-…”

Section: Hiz Towardsmentioning

confidence: 99%