fluvoxamine and REM-Sleep-Behavior-Disorder

Sleep disturbances are among the most commonly endorsed symptoms of post-traumatic stress disorder (PTSD). Treatment modalities that are effective for the waking symptoms of PTSD may have limited efficacy for post-traumatic sleep problems. The aim of this review is to summarize the evidence for empirically supported and/or utilized psychotherapeutic and pharmacological treatments for post-traumatic nightmares and insomnia. While there are few controlled studies of the applicability of general sleep-focused interventions to the management of the sleep disturbances in PTSD, evidence is growing to support several psychotherapeutic and pharmacological treatments. Future investigations should include trials that combine treatments focused on sleep with treatments effective in managing the waking symptoms of PTSD.

Topics: Antipsychotic Agents; Cognitive Behavioral Therapy; Dreams; Eye Movement Desensitization Reprocessing; Fluvoxamine; Humans; Piperazines; Prazosin; REM Sleep Behavior Disorder; Restless Legs Syndrome; Serotonin and Noradrenaline Reuptake Inhibitors; Sleep; Sleep Apnea, Obstructive; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Stress Disorders, Post-Traumatic; Trazodone; Triazoles

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia defined by intermittent loss of electromyographic atonia during REM sleep with emergence of complex and vigorous behaviors. Although the efficacy of several agents for treating RBD has been reported, a rationale for medication has not been established and the exact pathophysiological mechanisms of RBD are uncertain. We encountered a patient with idiopathic RBD that dramatically improved with selective serotonin reuptake inhibitors (SSRIs) and deteriorated with a 5-HT1A partial agonist, tandospirone. We report on the effects of these serotonin-modulating agents, which yield clues to a possible pharmacological approach to RBD.

Topics: Aged; Female; Fluvoxamine; Humans; Isoindoles; Paroxetine; Piperazines; Polysomnography; Pyrimidines; Reaction Time; REM Sleep Behavior Disorder; Selective Serotonin Reuptake Inhibitors; Serotonin Receptor Agonists; Sleep, REM; Treatment Outcome

Topics: Diagnosis, Differential; Dreams; Fluvoxamine; Humans; Male; Middle Aged; Motor Activity; Neurologic Examination; REM Sleep Behavior Disorder; Selective Serotonin Reuptake Inhibitors; Sleep-Wake Transition Disorders