Posted by zeugma on September 27, 2004, at 18:09:28
In reply to Re: Cymbalta and REM sleep - dreaming?, posted by VelvetElvis on September 27, 2004, at 0:32:34
> > the therapeutic effect of AD's is believed to be linked to their ability to inhibit REM sleep- or more exactly, to lengthen the amount of time it takes to enter REM after induction of sleep- known as 'REM latency.'
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> That's a new one to me. Can you post some cites please?
No problem:This one is especially relevant as it compares duloxetine (Cymbalta) and desipramine, two powerful inhibitors of NE reuptake. An interesting point made in this study is that 80 mg QD improved sleep continuity more than 60 mg BID.
For a disturbing look at some of the more ominious long-term side effects of the SSRI's, which I predict will rapidly wane in popularity, take a look at this:
A crucial fact to keep in mind is that the neuromodulators- serotonin, norepinephrine, dopamine, and acetylcholine- are integrally involved in global state changes of the brain such as the transition from sleep to waking, as well as in the construction of what Dr. Gerald Edelman- in a fascinating, difficult book, "A Universe of Consciousness"- calls 'value systems.' And this is in addition, too, to their well-known role in mood disorders.
As a side note, the sleep disorder narcolepsy is treated with drugs that enhance norepinephrine and serotonin, because it is these drugs that actually block the sudden onset of REM atonia known as cataplexy. it appears that the TCA's, which have more powerful effects on NE than on 5-HT, are also more effective in controlling cataplexy. The incidence of REM without atonia which is ordinarily only found in those in late stages of Parkinson's among SSRI users is disturbing, and suggests that serotonin is involved in the control of body movements. It also could be that the hyperserotonergetic state induced by SSRI's causes a hypodopaminergic state similar to that found in Parkinson's. MAOI's do not cause this loss of atonia, possibly because the boost the levels of dopamine as well as serotonin.
poster:zeugma
thread:395372
URL: http://www.dr-bob.org/babble/20040927/msgs/395968.html