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Somnambulistic-like Episodes Secondary to Combined Lithium-Neuroleptic Treatment

Published online by Cambridge University Press:  29 January 2018

Dennis S. Charney ,
Anthony Kales ,
Constantin R. Soldatos  and
J. Craig Nelson
Dennis S. Charney
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
Anthony Kales
Affiliation:
Department of Psychiatry and Sleep Research and Treatment Center, Pennsylvania State University School of Medicine, Hershey, Pennsylvania
Constantin R. Soldatos
Affiliation:
Department of Psychiatry and Sleep Research and Treatment Center, Pennsylvania State University School of Medicine, Hershey, Pennsylvania
J. Craig Nelson
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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Summary

Ten of 114 psychiatric patients undergoing combined lithium-neuroleptic treatment exhibited somnambulistic-like episodes. These episodes are differentiated from nocturnal wanderings and epileptic attacks during sleep; they occurred within two to three hours after sleep onset and were characterized by the patients appearing confused and walking about in a quiet, detached and clumsy manner. Generally, there was amnesia for the event. Since sleepwalking occurs out of slow wave sleep, the increase in slow wave sleep induced by lithium and certain neuroleptics may represent a neurophysiological mechanism responsible for these patients’ somnambulistic behaviour. The occurrence of grand mal seizures in two patients was probably unrelated to the somnambulistic-like episodes. However, persistence of the latter appears to be associated with drug-induced EEG irregularity.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 135 , Issue 5 , November 1979 , pp. 418 - 424
Copyright
Copyright © Royal College of Psychiatrists, 1979 

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References

Abe, K. & Shimakawa, M. (1966) Predisposition to sleepwalking. Psychiatric et Neurologia, 152, 306–12.CrossRefGoogle ScholarPubMed
Aivazian, G. H. & Reese, H. C. (1959) Clinical evaluation of promazine therapy for schizophrenia. Diseases of the Nervous System, 20, 472–7.Google Scholar
Bakwin, H. (1970) Sleepwalking in twins. The Lancet, it, 446–7.Google Scholar
Betts, T. A., Kalra, P. L. & Cooper, R. et al (1968) Epileptic fits as a probable side-effect of amitriptyline. The Lancet, i, 390–2.Google Scholar
Bixler, E. O., Kales, A. & Soldatos, C. R. et al (1979) Prevalence of sleep disorders: a survey of the Los Angeles Metropolitan Area. American Journal of Psychiatry (in press).Google Scholar
Broughton, R. J. (1968) Sleep disorders: disorders of arousal? Science, 159, 1070–8.Google Scholar
Broughton, R. J. & Gastaut, H. (1975) Recent sleep research on enuresis nocturna, sleepwalking, sleep terrors and confusional arousals. In Sleep 1974. Second European Congress of Sleep Research, Rome 1975. pp. 82–91. Basel: Karger.Google Scholar
Brown, D., Winsberg, B. G. & Bailer, I. et al (1973) Imipramine therapy and seizures: three children treated for hyperactive behaviour disorders. American Journal of Psychiatry, 130, 210–12.Google Scholar
Chernik, D. A. & Mendels, J. (1974) Longitudinal study of the effects of lithium carbonate on the sleep of hospitalized depressed patients. Biological Psychiatry, 9, 117–23.Google Scholar
Dallos, V. & Heathfield, K. (1969) Iatrogenic epilepsy due to antidepressant drugs. British Medical Journal, iv, 80–2.Google Scholar
Davis, E., Hayes, M. & Kirman, B. (1942) Somnambulism. The Lancet, i, 186.Google Scholar
Feinberg, I., Wender, P. H. & Koresko, R. L. et al (1969) Differential effects of chlorpromazine and phenobarbital on EEG sleep patterns. Journal of Psychiatric Research, 7, 101–9.CrossRefGoogle ScholarPubMed
Flemenbaum, A. (1976) Pavor nocturnus: a complication of single daily tricyclic or neuroleptic dosage. American Journal of Psychiatry, 133, 570–2.Google Scholar
Gastaut, H. & Broughton, R. (1965) A clinical and polygraphic study of episodic phenomena during sleep. In Recent Advances in Biological Psychiatry. (Ed. Wortis, J.). New York: Plenum Press.Google Scholar
Huapaya, L. (1976) Somnambulism and bedtime medication (letter to ed.). American Journal of Psychiatry, 133, 1207.Google Scholar
Itil, T. M. (1970) Convulsive and anticonvulsive properties of neuro-psychopharmaca. In Epilepsie: Problèmes actuels de Pharmacopsychiatrie, Vol. 4. (Ed. Niedermeyer, E.). Basel/New York: S. Karger.Google Scholar
Itil, T. M. & Soldatos, C. (1979) Clinical significance of the epileptogenic properties of psychotropic drugs. Electroencephalography and Clinical Neurophysiology, 46, 7, p.Google Scholar
Jacobson, A., Kales, A. & Lehmann, D. et al (1965) Somnambulism: all-night electroencephalographic studies. Science, 148, 975–7.Google Scholar
Jus, K., Beland, C. & Jus, A. et al (1975) Polygraphic night sleep pattern during chronic single and multiple dose administration. International Pharmacopsychiatry, 10, 58–63.CrossRefGoogle Scholar
Kales, A., Caldwell, A. & Kales, J. D. et al (1977a) Psychological characteristics of current vs. past sleepwalkers. Sleep Research, 6, 147.Google Scholar
Kales, A., Jacobson, A. & Paulson, M. J. et al (1966a) Somnambulism: psychophysiological correlates. I. All-night EEG studies. Archives of General Psychiatry, 14, 586–94.Google Scholar
Kales, A., Jacobson, A. & Paulson, M. J. et al (1966b) Somnambulism: psychophysiological correlates. II. Psychiatric interviews, psychological testing, and discussion. Archives of General Psychiatry, 14, 595–604.Google Scholar
Kales, A., Kales, J. D. & Humphrey, F. J. et al (1977b) Clinical characteristics of patients with sleepwalking. Sleep Research, 6, 171.Google Scholar
Kales, A., Weber, G. & Charney, D. S. et al (1977c) Familial occurrence of sleepwalking and night terrors. Sleep Research, 6, 172.Google Scholar
Kales, A. & Scharf, M. B. (1973) Sleep laboratory and clinical studies of the effects of benzodiazepines on sleep: flurazepam, diazepam, chlordiazepoxide, and RO 5–4200. In The Benzodiazepines. (Eds. Garattini, S., Mussini, E. and Randall, L. O.). New York: Raven Press.Google Scholar
Kaplan, J., Dawson, S. & Vaughan, T. et al (1974) Effect of prolonged chlorpromazine administration on the sleep of chronic schizophrenics. Archives of General Psychiatry, 31, 62–6.CrossRefGoogle ScholarPubMed
Kleitman, N. (1963) Sleep and Wakefulness, pp. 282–4. Chicago: University Press.Google Scholar
Kupfer, D., Reynolds, C. F. & Weiss, B. L. et al (1974) Lithium carbonate and sleep in affective disorders. Archives of General Psychiatry, 30, 79–84.Google Scholar
Lester, B. K., Coulter, J. D. & Cowden, L. C. et al (1971) Chlorpromazine and human sleep. Psychopharmacologia, 20, 280–7.Google Scholar
Logothetis, J. (1967) Spontaneous epileptic seizures and electroencephalographic changes in the course of phenothiazine therapy. Neurology, 17, 869–77.CrossRefGoogle ScholarPubMed
Luchins, D. J., Sherwood, P. J. & Gillin, C. et al (1978) Filicide during psychotropic-induced somnambulism: a case report. American Journal of Psychiatry, 135, 1404–5.Google ScholarPubMed
Neil, J. F., Merikangas, J. R. & Davies, R. K. et al (1978) Validity and clinical utility of neuroleptic facilitated electroencephalography in psychotic patients. Clinical Electroencephalography, 9, 38–48.Google Scholar
Pedley, T. & Guilleminault, C. (1977) Episodic nocturnal wanderings responsive to anticonvulsive drug therapy. Annals of Neurology, 2, 30–5.Google Scholar
Thomas, C. & Pederson, L. (1963) Psychobiological studies. II: Sleep habits of healthy young adults with observations on levels of cholesterol and circulating eosinophils. Journal of Chronic Diseases, 16, 1099–114.Google Scholar
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