Sleepwalking, A Possible Side Effect of Antipsychotic Medication

Seeman, Mary V.

doi:10.1007/s11126-010-9149-8

Cited by 29 publications

(25 citation statements)

References 43 publications

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“…Thus there is some evidence for an association between depression and SW. Furthermore, a number of drugs have been reported to occasionally induce SW: hypnotics, antipsychotics, antihistaminics, alcohol and especially antidepressants, including SSRI [26,27,28]. Serotonin (5-HT) neurons originating from the dorsal raphe nucleus project to the cholinergic laterodorsal and pedunculopontine tegmental areas, inhibiting ‘REM-on' neurons and therefore inhibiting REM sleep [29].…”

Section: Discussionmentioning

confidence: 99%

Sleepwalking, REM Sleep Behaviour Disorder and Overlap Parasomnia in Patients with Parkinson's Disease

et al. 2013

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Background/Aims: In a questionnaire survey, we identified 36 (9%) of 417 Parkinson's disease (PD) patients with sleepwalking (SW); 72% of them also had a history of REM sleep behaviour disorder (RBD). We aimed to assess the clinical and polysomnographic characteristics of SW in PD and to compare them to patients with PD with and without a history of RBD. Methods: We performed video-polysomnography and detailed clinical examination in 30 PD patients from the above-mentioned survey: 10 patients with a history of SW, 10 patients with a history of RBD, and 10 patients with no history of either SW or RBD. Results: PD patients with SW had higher depression, anxiety and Hoehn & Yahr scores and lower activities of daily living scores than patients without a history of RBD but did not differ from patients with RBD. Patients with SW and RBD also had more often dyskinesia and hallucinations. By polysomnography, RBD was observed in 8 patients with SW and in all patients with a history of RBD. A total of 5 patients without a history of either SW or RBD had REM sleep without atonia without behavioural peculiarities. Conclusion: SW in PD is associated with depression, higher disease severity and functional disability. The simultaneous occurrence of SW and RBD (overlap parasomnia) in most patients suggests a common underlying disturbance of motor control during sleep in PD, with variable manifestations in different sleep stages.

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Section: Discussionmentioning

confidence: 99%

Sleepwalking, REM Sleep Behaviour Disorder and Overlap Parasomnia in Patients with Parkinson's Disease

et al. 2013

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“…I have wondered whether he may have been a sleepwalker. Like hypothermia, sleepwalking is a rarely recognized side effect of antipsychotic medication [4]. The naked streaking in the hospital at night may have been a form of sleepwalking, which would account for his afterwards not understanding what he had done wrong.…”

Section: Discussionmentioning

confidence: 99%

Antipsychotics, Hypothermia, Undressing, and Death

Seeman¹

2017

Glob J Medical Clin Case Rep

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One of the lesser-known adverse effects of antipsychotic medication is hypothermia, a signifi cant and protracted plunge in body temperature. Known risk factors are older age and exposure to a newfor-the-person antipsychotic drug. Hypothermia impairs cognitive function, often resulting in a delirium that can paradoxically induce the prescription of escalating doses of the offending drug. As hypothermia increases, the subjective experience of the person may be one of overwhelming heat that can lead to the person shedding protective clothing, an action that can precipitate death. Case Report Antipsychotics Case ExampleA 62-year-old male patient had, for many years, been suffering from schizophrenia and had more recently Three days later, he was found frozen to death on the sidewalk outside his residence. He was completely naked; his clothes were stacked in a neat pile beside him. Although there was no suicide note, the coroner attributed the death to suicide. Given the patient's psychiatric history, the conclusion was that he had deliberately walked out into the cold and taken off his clothes in order to freeze himself to death. Suicide while in the nude is, apparently, a known entity [2], (though purposefully freezing oneself to death has never been reported in this context). The patient's extended family and long-term clinicians stated that there was no previous history of suicidal threats or gestures; nevertheless, the care providers who had looked after him during his recent hospital stay and thought of him as "attention-seeking" considered it possible that he had deliberately staged a melodramatic ending [3] to an otherwise uneventful life. DiscussionThe death of this patient occurred twenty years ago, but it has remained a puzzle. Having known the patient for many years, I cannot believe that he committed suicide. I have wondered whether he may have been a sleepwalker. Like hypothermia, sleepwalking is a rarely recognized side effect of antipsychotic medication [4]. The naked streaking in the hospital at night may have been a form of sleepwalking, which would account for his afterwards not understanding what he had done wrong. The fi nal walk out into the street and the shedding of clothes may have been the action of a sleepwalker.The other explanatory hypothesis is hypothermia, defi ned as body temperature falling below 35°C. While malignant hyperthermia is a well-known and potentially fatal adverse effect of antipsychotics, its opposite, hypothermia, is less wellrecognized. In 2007, van Marum [5], using the World Health Organization database, reviewed 480 cases of hypothermia associated with the use of antipsychotic medication. A large number of these, 44, were linked to olanzapine.

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“…Her case worker misunderstood the situation and attributed the client's barricading behavior to paranoia. She recommended that her antipsychotic dose be raised, which only made the sleepwalking worse (8,9).…”

Section: Examplesmentioning

confidence: 99%

Assessing the Effects of Antipsychotics on Parenting

Seeman

2017

Women Health Bull

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Context: Mental health professionals interact with substantial numbers of parents, mainly mothers, who suffer from severe mental disorders and who are treated, acutely or chronically, with antipsychotic medication. The behavior of these clients is affected by their primary illness but also by many other factors, including their drug regimen. The treating team, however, does not always recognize that a drug can profoundly impact cognition and behavior. The aim of this paper is to inform non-medical mental health workers how antipsychotic medication (AP) can influence client cognition and behavior, and thereby impact the safety of the client's children. Indirectly, APs can also affect the immediate and longer-term behavior of the children. Evidence Acquisition: This article qualitatively reviews the very sparse literature on antipsychotic effects on cognition and behavior in populations of mentally ill mothers of young children. This narrative review includes case illustrations taken from a clinic for women with psychotic disorders. Also included are references to studies of rodent maternal behavior, as influenced by antipsychotic drugs. Results: Animal studies have shown that maternal behavior in rodents is impaired by antipsychotic drugs. In humans, drug effects such as sedation, dizziness, indicated thinking, tardive dyskinesia, increased appetite, and sleepwalking, as well as client beliefs about and attitudes toward their drugs, can affect their problem solving, decision-making, and behavior and, thus, play a critical role in child custody determinations. Behavior induced by drugs includes issues of tolerance, withdrawal, and sensitization. Importantly, there are major safety concerns related to APs. Conclusions: Listening attentively when clients speak about their drugs and understanding potential drug effects help mental health professionals increase their therapeutic efficacy and make sound decisions about clients and their children.

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Sleepwalking, A Possible Side Effect of Antipsychotic Medication

Cited by 29 publications

References 43 publications

Sleepwalking, REM Sleep Behaviour Disorder and Overlap Parasomnia in Patients with Parkinson's Disease

Sleepwalking, REM Sleep Behaviour Disorder and Overlap Parasomnia in Patients with Parkinson's Disease

Antipsychotics, Hypothermia, Undressing, and Death

Assessing the Effects of Antipsychotics on Parenting

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