SSRIs Increase Sleep Disorder Risk, May Contribute to Dementia Risk

Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), increase the risk of rapid eye movement (REM) sleep behavioral disorders (RBDs) in the elderly population, according to new research.

The findings were presented earlier this month at the Institute of Psychiatric Services: The Mental Health Services Conference.

REM sleep decreases and fragmented sleep increase with age. A lack of REM sleep may contribute to physical and mental problems in the elderly, including depression. Although antidepressants are a common treatment for depression in the elderly, the treatment may cause a change in the physiological patterns of sleep.

To further understand the association between antidepressants and REM sleep disorders, the researchers analyzed 10 systemic reviews, retrospective studies, and prospective studies published between 2011 and 2016.

The researchers included studies of patients who were age 50 years or older, had REM sleep disorders, and were taking antidepressants for depression.

Their analysis showed that antidepressants significantly affect sleep architecture by increasing sleep latency and decreasing REM sleep duration in elderly patients.

Antidepressants were also associated with REM sleep disorders including nightmares and RBDs. Patients taking SSRIs were most likely to have a sleep disorder.

Further review suggested that RBDs may be an early sign of neurodegeneration that can progress to dementia.

“Use of [antidepressants] can affect REM sleep in the elderly through various mechanisms,” the researchers concluded. “RBDs can be an early sign of neurodegeneration, and antidepressants can put a patient at risk for neurodegenerative diseases.

“Psychiatrists must screen out neurodegenerative signs/symptoms and discuss with the patient before prescribing antidepressants for the treatment of depression in elderly patients. More research is required to study antidepressant effects on REM sleep disorder.”

—Amanda Balbi

Reference:

Tahir MA, Jahan N, Zeshan M. Effect of antidepressants on REM sleep in the elderly population: a literature review. Paper presented at: Institute of Psychiatric Services (IPS): The Mental Health Services Conference; October 6-9, 2016; Washington, D.C. file:///Users/abalbi/Downloads/2016-Syllabus.pdf. Accessed October 17, 2016.