FLUOXETINE-INDUCED SLEEP DISTURBANCE IN DEPRESSED-PATIENTS

Abnormal polysomnographic (PSG) features, most notably increased elect romyographic (EMG) tone and eye movements during non-REM sleep have be en observed during sleep in fluoxetine-treated depressed patients. How ever, the relationship between these PSG features and sleep disruption is unclear. Nine depressed patients treated with 10 to 80 mg of fluox etine and six unmedicated, depressed patients were studied polysomnogr aphically on two consecutive nights during which sleep parameters, tra nsient arousals, and eye movements were measured. The fluoxetine group experienced a lower-average sleep efficiency index (SEI) and signific antly more eye movements and arousals during non-REM sleep than the co ntrol group. Eye movement and arousal counts were significantly correl ated. In addition, clinically significant periodic limb movement disor der (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 tre ated with fluoxetine.