LONGECITY

Has anybody experienced sleepwalking while taking an SSRI?

 

I just found out tonight that since starting lexapro a little over a month ago, I've been sleepwalking.  Like hardcore sleepwalking.

 

I only found out because I was missing some ice cream treats and was wondering who took them, and then my sister in law said that it probably happened while I was sleepwalking.

 

I didn't know I was sleepwalking!!!  Haha

 

I even found out that I took my car, drove it into a neighbor's driveway and just sat and stared for 30 minutes.  I've sleeptalked in the past sans medication, but never anything like this.

 

I've been taking it at night so I've going to try taking it in the day to see if that fixes it.  Fortunately, I already have an appointment next week.

 

Other than discontinuing the SSRI, is there another solution to fixing this?

 

 

Hmm... Do you have some other issues with your sleep? Like, for instance, does Escitalopram (lexapro) cause you to get Rest-less-Legs? As I understand it, the worsening of such symptoms are connected to the worsening of Sleep-walking.

 

https://en.wikipedia...iated_disorders

 

"The study found that children with chronic parasomnias may often also present SDB or, to a lesser extent, RLS. Furthermore, the disappearance of the parasomnias after the treatment of the SDB or RLS periodic limb movement syndrome suggests that the latter may trigger the former."

 

 

Now, I would possibly suggest you try Gabapentin, but apparently sleep-walking happens DURING STAGE 4 SLEEP! 0_o So, since GabaP increases time in stage 4 sleep, it could possibly worsen the issues of somnambulism (sleepwalking - litterally, in Latin).

 

Another option, if you have RLS, might be dopamine-agonists, like Pramipexole - they don't increase time in stage 4 sleep to the same extent, to my knowledge.

 

 

Hmm... now that I think about it... I do believe there is some evidence that SSRI's diminish dopaminergic activity in the brain, so possibly you're one of the folks whom are more sensitive to this effect, and it triggers your Somnambulism?

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Interesting. There are 2 people in my family who sleep walked, one as a young child, another only after taking sleep meds. Both of them have that restless legs and are more prone to anxiety. Googling reveals a link between sleepwalking and mental diseases.

There isn't any RLS.

 

But the idea of me being sensitive to the effects of SSRIs diminishing dopaminergic activity in the brain sounds like it might fit the bill since I do have adhd.  I also take the primarily noradrenergic TCA nortriptyline, but I've been taking that for well over a year and never had issues till I started the lexapro.  I also take adderall in the day.  

There isn't any RLS.

 

But the idea of me being sensitive to the effects of SSRIs diminishing dopaminergic activity in the brain sounds like it might fit the bill since I do have adhd.  I also take the primarily noradrenergic TCA nortriptyline, but I've been taking that for well over a year and never had issues till I started the lexapro.  I also take adderall in the day.  

 

Oh, you have ADHD as well? And you've got a nifty pack of Adderall lying about... for a small experiment, consider using a small dosage of Adderall, much smaller than your usual dosage, when you go to bed - this has been reported to help ADHD-ers with RLS, so possibly, it could increase DA-activity enough while you sleep, to prevent any somnambulism.

I'm too busy right now, jacked up on Reboxetine, NSI-189, Tianeptine and MODAFINIL to have a closer look at Nortriptyline, but this might have something to do with the combo of that and Escitalopram (lexapro). TCA's are known to have more side-effects than more modern drugs, and perhaps this has something to do with the anticholinergic actions of Nort... Anticholinergics f*ck with my sleep as well. (I have PLMD, a disase related to RLS, but instead of tingling sensations while awake, it causes spastic movements of the arms and legs while asleep, which prevents one from going into Stage 4 sleep)

 

Acetacholine and Dopamine exist in a sort of see-saw, if you lower the activity of one, the other goes up.

 

Hmm... wait a minute... that would mean that you'd be experiencing INCREASED DA during sleep! Since adderall wears off, and Nortrip keeps suppressing aCh.

 

Well, anyway, try out the low-dose Adderall at bed-time.

Okay, now I've spoken to my brother too and this has been going on long before the lexapro was added.  But it started way after either the nortriptyline or the adderall was started...

 

I wonder if racetams taken in the day can do this.  I also take aniracetam for generalized anxiety, word fluency, to smooth out the adderall, and to help me be more comfortable and open in social situations.  

Racetams are a bit of an untested territory when it comes to these things... Other than Piracetam, they are all poorly studied, so it's quite hard to say if that's the case.

 

I'm looking into Nortriptyline and it's actually prescribed for some Parasomnias! But here is some data on its effects on sleep-structure:

 

 

http://eprints.bourn...publication.pdf

 

Nortriptyline
Depressed patients
(Reynolds, III et al.,1997)
demonstrated that nortriptyline (80 -120mg)
was associated with  longer sleep  latency  than  placebo.
Nortriptyline  also  showed  initial  suppression  of  REM  sleep,  with prolonged REM  latency and reduced REM proportion, but this rebounded  in  later REM periods to show greater REM production and density
than placebo.

 

 

http://www.bpac.org....arasomnias.aspx

(nifty diagram explaining sleep-architecture)

 

According to what I've read, Somnambulism occurs in non-REM sleep - so it's not related to when you dream, it's related to deeper sleep, Stage 4. Nortriptyline is a fairly potent 5ht2a-antagonist - and such drugs, have been known to increase time in Stage 4 sleep - ussually, this is BENIGN, since stage 4 sleep is where the body truly repairs itself and refreshes - but it's apparently also the part wherein parasomnias can start messing about.

 

As such, it's possible that Nortriptyline is behind your symptoms. When do you take it? Perhaps it might be more beneficial to take it during the day, so as to have the blood-levels drop when you're going to sleep.

 

 

However, I also found this info:

 

https://www.ncbi.nlm...les/PMC2917078/

 

In some cases of nontypical history with very complex stereotypical automatism or unusual behaviors, seizures (especially frontal or temporal lobe epilepsy or partial complex seizures) should be suspected.

 

 

The description sounds an awful lot like you... started out late in life, you do complex stuff when you sleep...

 

As I understand it, antidepressants lower seizure threshold - and TCA's were notorious for lowering this more than SSRI's, one of the reasons why the shift to SSRI's occured. Try and get an EEG and see if there are any abnormalities, a sleep-study would be optimal.

 

It's mentioned that compounds which increase REM-sleep, while shrinking stage 4 sleep, like the Benzo's, are useful in treating this. Some short-acting Benzo should be ideal, since these episodes only occur during the first stage of sleep, and generally not during the later parts of the night. (the studies mention lorazepam, but that's waay too long-acting for me - 10 hours?? nuh-uh - you only need about 4-5 hours, I say)

 

Diazepam, the classic Valium, has a duration of action of about 4-5 hours - that should be enough to suppress stage 4 sleep enough to keep you in bed.

Edited by Stinkorninjor, 23 September 2017 - 07:09 AM.

^

 

Wow.  Thanks a whole bunch for that very well informed and thought out response.  Thanks!  

 

I always like to be a partner in my behavioral health with my P-doc and she definitely listens to what I have to say so I always like to be as informed as possible when bringing up specific issues.  I think this could help.  

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^

 

Wow.  Thanks a whole bunch for that very well informed and thought out response.  Thanks!  

 

I always like to be a partner in my behavioral health with my P-doc and she definitely listens to what I have to say so I always like to be as informed as possible when bringing up specific issues.  I think this could help.  

 

You're welcome! ^^ I only do unto others what I want others to do for me - helping others is good for the soul, especially when we're all struggling with mental and neurological issues - we're all in this together and should try to help each other out!
 

I hope this helps you and your Doc. to figure out some way to solve your issues.