fluvoxamine and Sleep-Wake-Disorders

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

Selective serotonin [5-hydroxytryptamine (5-HT)] reuptake inhibitors (SSRIs) and the 5-HT noradrenaline reuptake inhibitor, venlafaxine, are mainstays in treatment for depression. The highly specific actions of SSRIs of enhancing serotonergic neurotransmission appears to explain their benefit, while lack of direct actions on other neurotransmitter systems is responsible for their superior safety profile compared with tricyclic antidepressants. Although SSRIs (and venlafaxine) have similar adverse effects, certain differences are emerging. Fluvoxamine may have fewer effects on sexual dysfunction and sleep pattern. SSRIs have a cardiovascular safety profile superior to that of tricyclic antidepressants for patients with cardiovascular disease; fluvoxamine is safe in patients with cardiovascular disease and in the elderly. A discontinuation syndrome may develop upon abrupt SSRI cessation. SSRIs are more tolerable than tricyclic antidepressants in overdose, and there is no conclusive evidence to suggest that they are associated with an increased risk of suicide. Although the literature suggests that there are no clinically significant differences in efficacy amongst SSRIs, treatment decisions need to be based on considerations such as patient acceptability, response history and toxicity.

Topics: Antidepressive Agents, Second-Generation; Body Weight; Central Nervous System Diseases; Depressive Disorder; Fluvoxamine; Humans; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological; Sleep Wake Disorders

The need to subtype patients with affective disorders on the basis of biological characteristics is well recognized, and much of the research in this area has focused on the serotonergic system. Biological subtyping can be approached using both peripheral and central markers. Peripheral markers include platelet serotonin concentrations, the density and affinity of platelet serotonin reuptake and platelet 5-HT2 receptors, and plasma serotonin concentrations. Central markers include cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) concentrations, and endocrine, psychological and body temperature responses to challenge tests with a number of serotonergic drugs. More recently, the role of selective serotonin reuptake inhibitors (SSRIs) and other serotonergic drugs in sleep, and in the control of cardiovascular homeostasis, has been studied. This may provide a greater understanding of the mechanisms of serotonin dysregulation in affective disorders, and may ultimately improve treatment of these conditions.

Topics: Biomarkers; Blood Pressure; Depressive Disorder; Fluvoxamine; Heart Rate; Humans; Lithium; Lofepramine; Mood Disorders; Selective Serotonin Reuptake Inhibitors; Sleep Wake Disorders; Time Factors

Authors studied 70 patients with panic disorder, 30 men and 40 women, mean age 34,5±1,8 years. All patients had insomnia. Patients were classified into the main and control groups. Patients of the control group received antidepressants only (fevarin in dosage 150 mg daily). Patients of the main group were additionally treated with mexidol (375 mg daily). The treatment duration was two weeks. A clinical and instrumental (polysomnography) examination revealed that the use of mexidol enhanced the decrease in anxiety disorders, autonomic disturbances and insomnia and improved quality of life of the patients.

Topics: Adult; Antidepressive Agents, Second-Generation; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Fluvoxamine; Humans; Male; Panic Disorder; Picolines; Polysomnography; Sleep; Sleep Wake Disorders; Treatment Outcome

Antidepressants have been recommended for the treatment of post-stroke depression (PSD). The purpose of this study was to evaluate the effect of fluvoxamine maleate, a selective serotonin re-uptake inhibitor (SSRI), on depressive state, sleep disturbance, and serum melatonin levels in patients with depressive state after cerebral infarction.. Nineteen patients who were hospitalized for cerebral infarction and scored 40 points or higher on the Self Depression Scale (SDS) were enrolled in this study. Nine of the 19 patients received fluvoxamine as a treatment group and the other 10 patients were used as untreated controls. Before and after commencing the drug therapy, the patients were assessed by the SDS, Pittsburgh Sleep Quality Index (PSQI), Japan Stroke Scale for Depression (JSSD), and Japan Stroke Scale for Emotional Disturbance (JSSE), and their serum melatonin levels were measured. The control group underwent the same evaluations as the treatment group.. The SDS score improved in the treatment group at 1 week after the start of drug treatment, and in the control group at 1 and 2 weeks into the observation period. In the treatment group, the JSSD and PSQI scores improved and serum melatonin levels increased.. The administration of fluvoxamine to patients with depressive state after cerebral infarction alleviated both the depressive state and sleep disturbances. Increased melatonin levels by the administration of fluvoxamine may contribute to improvement in sleep disturbance, one of the major symptoms of depression.

Topics: Aged; Aged, 80 and over; Antidepressive Agents, Second-Generation; Cerebral Infarction; Depression; Female; Fluvoxamine; Humans; Male; Melatonin; Selective Serotonin Reuptake Inhibitors; Sleep Wake Disorders; Stroke

The present study examined sleep-related problems (SRPs) among a large sample (n = 128) of youth with anxiety disorders (i.e., generalized, separation, and social). The frequency of eight specific SRPs was examined in relation to age, gender, type of anxiety disorder, anxiety severity, and functional impairment. The impact of pharmacological treatment (fluvoxamine versus pill placebo) in reducing SRPs also was examined.. As part of a large, double-blind, randomized, controlled trial (Research Units on Pediatric Psychopharmacology Anxiety Study Group), clinician and parent reports of SRPs were examined among children and adolescents, ages 6 to 17 years, before and after treatment.. Eighty-eight percent of youth experienced at least one SRP, and a majority (55%) experienced three or more. Total SRPs were positively associated with anxiety severity and interference in family functioning. Significantly greater reductions in SRPs were found among children treated with fluvoxamine compared with placebo.. These findings indicate that SRPs are commonly associated with childhood anxiety disorders and suggest a need for the assessment of and attention to these problems in research and clinical settings.

Topics: Adolescent; Anti-Anxiety Agents; Anxiety Disorders; Anxiety, Separation; Child; Double-Blind Method; Female; Fluvoxamine; Humans; Male; Phobic Disorders; Sleep Wake Disorders

To report a case of recurrent isolated sleep paralysis (RISP), a benign parasomnia with worrisome and frightening sleep paralysis episodes.. description: We describe a case of RISP in a sixteen-year-old girl who seeks medical attention for anxiety symptoms. The sleep paralysis and associated auditory and tactile hallucinations began three years before with worsening in the last year, causing fear of sleeping. The episodes were intensely frightening causing negative impact in patient's sleep, school performance and social function. Medical conditions were excluded, and she started treatment with a selective serotonin reuptake inhibitor with complete resolution of symptoms.. Sleep complaints are often devalued. Therefore, clinicians should actively ask their patients about their sleep during health assessment.

Topics: Academic Performance; Administration, Oral; Adolescent; Anxiety; Diagnosis, Differential; Fear; Female; Fluvoxamine; Hallucinations; Humans; Recurrence; Selective Serotonin Reuptake Inhibitors; Sleep Paralysis; Sleep Wake Disorders; Social Change; Treatment Outcome

An 8 year-old boy with Asperger's syndrome had difficulties in communicating with his teachers and classmates. He occasionally stole out of the classroom. He could not sleep at night recalling his awful experience and kept crying every night and refused to go to school. The treatment with fluvoxamine was started at the dose of 25 mg daily. Four weeks after the treatment, his repetitive behavior and hyperactivity decreased and night crying diminished. Although he still has difficulties in communicating with others, he is now able to attend extra-curricular classes in a private school. Fluvoxamine, a selective serotonin re-uptake inhibitor that has been mainly used for patients with depression and obsessive-compulsive disorder, might be effective for compulsive symptoms and sleep disturbance of patients with pervasive developmental disorders.

Topics: Asperger Syndrome; Child; Fluvoxamine; Humans; Male; Selective Serotonin Reuptake Inhibitors; Sleep Wake Disorders; Stereotypic Movement Disorder; Treatment Outcome

Topics: Adult; Antidepressive Agents; Drug Interactions; Drug Therapy, Combination; Female; Fluvoxamine; Humans; Lithium; Lithium Carbonate; Oximes; Sleep Wake Disorders