Bupropion SR reduces periodic limb movements associated with arousals fromsleep in depressed patients with periodic limb movement disorder

Background: Antidepressant-induced periodic limb movement disorder (PLMD) m ay limit the tolerability of some antidepressant medications and interfere with treatment response. Given the role of dopamine in PLMD and the effects of bupropion sustained-release (SR) on central dopaminergic function, we h ypothesized that bupropion SR would not be associated with antidepressant-i nduced PLMD. Method: In an expanded case-series design, we compared the effects of bupro pion SR, after about 10 weeks of treatment, on measures of PLMD, depression , and sleep in 5 depressed (Research Diagnostic Criteria) patients who also met criteria for having pretreatment PLMD. Depression was measured using t he Beck Depression Inventory and the Hamilton Rating Scale for Depression. Patients were considered to have PLMD if polysomnographic recordings showed > 5 periodic limb movements/hour of sleep that were associated with arousa ls from sleep. Results: Bupropion SR treatment was associated with a reduction in measures of PLMD and an improvement in depression. Conclusion: These results show that bupropion SR is not associated with ant idepressant-induced PLMD, Rather, bupropion SR treatment reduces objective measures of PLMD in depressed patients with the disorder.