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Re: MAOI and REM sleep: Anyone?

Posted by Adam on October 21, 2001, at 18:34:16

In reply to MAOI and REM sleep: Anyone?, posted by Ant-Rock on October 16, 2001, at 20:21:08

Hey, Ant,

I did a bit of reading on the subject, since I had similar problems with loss of REM sleep (and loss of sleep in general) on selegiline.

One thing I think a lot of people ignore about the MAOIs is that they also inhibit the breakdown of histamine. As it turns out histaminergic signaling seems to be deeply involved in sleep mechanics, e.g. circadian rhythms and paradoxical sleep.

A pointer to a good, recent article of some relevance is here:

I made, myself, a couple of observations: Mirtazapine, which acts most potently as a histamine H1 antagonist, made me dream like crazy. Technicolour, super-hi-fi dreams from another planet. On selegiline, taking diphenhydramine would allow me to both sleep and dream. I figured, well, histaminergic neurons must be involved somehow, and the literature seems to bear that suspicion out.

I had an idea about what to do next, before I got off selegiline entirely: try a better antihistamine than diphenhydramine (better in that it would be more specific for the H1 receptor and not have all the side-effects) to help me sleep. One thing I thought of was low-dose mirtazapine. I think 7.5mg of mirtazapine before bedtime would be pretty safe on tranylcypromine, since it generally has very little activity at that dose on anything except the histamine H1 receptor. There may be other, better choices out there.

You could try an experiment with diphenhydramine just to see if it helps. One other possiblility might be addition of a trycyclic antidepressant, like desipramine, which also is a potent antihistamine, as well as a muscarinic-cholinergic receptor antagonist (those are also involved in sleep-wakefulness cycles).

Just a thought. Good luck!


> Does anyone know if Ambien restores loss of REM sleep from taking Parnate(70mg)?
> If not , is there something that does?
> Thanks,
> Anthony




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