ParkinsonCanadaV1, Pmc, Corpus, bibRecord, 000684

Antidepressants and REM Sleep Behavior Disorder: Isolated Side Effect or Neurodegenerative Signal?

Identifieur interne : 000684 ( Pmc/Corpus ); précédent : 000683; suivant : 000685

Antidepressants and REM Sleep Behavior Disorder: Isolated Side Effect or Neurodegenerative Signal?

Auteurs : Ronald B. Postuma ; Jean-Francois Gagnon ; Maria Tuineaig ; Josie-Anne Bertrand ; Veronique Latreille ; Catherine Desjardins ; Jacques Y. Montplaisir

Source :

Sleep [ 0161-8105 ] ; 2013.

RBID : PMC:3792373

Abstract

Objectives:

Antidepressants, among the most commonly prescribed medications, trigger symptoms of REM sleep behavior disorder (RBD) in up to 6% of users. Idiopathic RBD is a very strong prodromal marker of Parkinson disease and other synuclein-mediated neurodegenerative syndromes. It is therefore critically important to understand whether antidepressant-associated RBD is an independent pharmacologic syndrome or a sign of possible prodromal neurodegeneration.

Design:

Prospective cohort study.

Setting:

Tertiary sleep disorders center.

Participants:

100 patients with idiopathic RBD, all with diagnosis confirmed on polysomnography, stratified to baseline antidepressant use, with 45 matched controls.

Measurements/Results:

Of 100 patients, 27 were taking antidepressants. Compared to matched controls, RBD patients taking antidepressants demonstrated significant abnormalities of 12/14 neurodegenerative markers tested, including olfaction (P = 0.007), color vision (P = 0.004), Unified Parkinson Disease Rating Scale II and III (P < 0.001 and 0.007), timed up-and-go (P = 0.003), alternate tap test (P = 0.002), Purdue Pegboard (P = 0.007), systolic blood pressure drop (P = 0.029), erectile dysfunction (P = 0.002), constipation (P = 0.003), depression indices (P < 0.001), and prevalence of mild cognitive impairment (13% vs. 60%, P < 0.001). All these abnormalities were indistinguishable in severity from RBD patients not taking antidepressants. However, on prospective follow-up, RBD patients taking antidepressants had a lower risk of developing neurodegenerative disease than those without antidepressant use (5-year risk = 22% vs. 59%, RR = 0.22, 95%CI = 0.06, 0.74).

Conclusions:

Although patients with antidepressant-associated RBD have a lower risk of neurodegeneration than patients with “purely-idiopathic” RBD, markers of prodromal neurodegeneration are still clearly present. Development of RBD with antidepressants can be an early signal of an underlying neurodegenerative disease.

Citation:

Postuma RB; Gagnon JF; Tuineaig M; Bertrand JA; Latreille V; Desjardins C; Montplaisir JY. Antidepressants and REM sleep behavior disorder: isolated side effect or neurodegenerative signal? SLEEP 2013;36(11):1579-1585.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792373

DOI: 10.5665/sleep.3102
PubMed: 24179289
PubMed Central: 3792373

Links to Exploration step

PMC:3792373

Le document en format XML

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<author><name sortKey="Postuma, Ronald B" sort="Postuma, Ronald B" uniqKey="Postuma R" first="Ronald B." last="Postuma">Ronald B. Postuma</name>
<affiliation><nlm:aff id="aff1">Department of Neurology, McGill University, Montreal General Hospital, Montreal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gagnon, Jean Francois" sort="Gagnon, Jean Francois" uniqKey="Gagnon J" first="Jean-Francois" last="Gagnon">Jean-Francois Gagnon</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff3">Department of Psychology, Université du Québec à Montréal, Montreal, Québec, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tuineaig, Maria" sort="Tuineaig, Maria" uniqKey="Tuineaig M" first="Maria" last="Tuineaig">Maria Tuineaig</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
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</author>
<author><name sortKey="Bertrand, Josie Anne" sort="Bertrand, Josie Anne" uniqKey="Bertrand J" first="Josie-Anne" last="Bertrand">Josie-Anne Bertrand</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff4">Department of Psychology, Université de Montréal, Montreal, Québec, Canada</nlm:aff>
</affiliation>
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<author><name sortKey="Latreille, Veronique" sort="Latreille, Veronique" uniqKey="Latreille V" first="Veronique" last="Latreille">Veronique Latreille</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff4">Department of Psychology, Université de Montréal, Montreal, Québec, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Desjardins, Catherine" sort="Desjardins, Catherine" uniqKey="Desjardins C" first="Catherine" last="Desjardins">Catherine Desjardins</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Montplaisir, Jacques Y" sort="Montplaisir, Jacques Y" uniqKey="Montplaisir J" first="Jacques Y." last="Montplaisir">Jacques Y. Montplaisir</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff5">Department of Psychiatry, Université de Montréal, Montreal, Québec, Canada</nlm:aff>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Antidepressants and REM Sleep Behavior Disorder: Isolated Side Effect or Neurodegenerative Signal?</title>
<author><name sortKey="Postuma, Ronald B" sort="Postuma, Ronald B" uniqKey="Postuma R" first="Ronald B." last="Postuma">Ronald B. Postuma</name>
<affiliation><nlm:aff id="aff1">Department of Neurology, McGill University, Montreal General Hospital, Montreal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
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<author><name sortKey="Gagnon, Jean Francois" sort="Gagnon, Jean Francois" uniqKey="Gagnon J" first="Jean-Francois" last="Gagnon">Jean-Francois Gagnon</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
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<affiliation><nlm:aff id="aff3">Department of Psychology, Université du Québec à Montréal, Montreal, Québec, Canada</nlm:aff>
</affiliation>
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<author><name sortKey="Tuineaig, Maria" sort="Tuineaig, Maria" uniqKey="Tuineaig M" first="Maria" last="Tuineaig">Maria Tuineaig</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bertrand, Josie Anne" sort="Bertrand, Josie Anne" uniqKey="Bertrand J" first="Josie-Anne" last="Bertrand">Josie-Anne Bertrand</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff4">Department of Psychology, Université de Montréal, Montreal, Québec, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Latreille, Veronique" sort="Latreille, Veronique" uniqKey="Latreille V" first="Veronique" last="Latreille">Veronique Latreille</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff4">Department of Psychology, Université de Montréal, Montreal, Québec, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Desjardins, Catherine" sort="Desjardins, Catherine" uniqKey="Desjardins C" first="Catherine" last="Desjardins">Catherine Desjardins</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Montplaisir, Jacques Y" sort="Montplaisir, Jacques Y" uniqKey="Montplaisir J" first="Jacques Y." last="Montplaisir">Jacques Y. Montplaisir</name>
<affiliation><nlm:aff id="aff2">Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff5">Department of Psychiatry, Université de Montréal, Montreal, Québec, Canada</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Sleep</title>
<idno type="ISSN">0161-8105</idno>
<idno type="eISSN">1550-9109</idno>
<imprint><date when="2013">2013</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Objectives:</title>
<p>Antidepressants, among the most commonly prescribed medications, trigger symptoms of REM sleep behavior disorder (RBD) in up to 6% of users. Idiopathic RBD is a very strong prodromal marker of Parkinson disease and other synuclein-mediated neurodegenerative syndromes. It is therefore critically important to understand whether antidepressant-associated RBD is an independent pharmacologic syndrome or a sign of possible prodromal neurodegeneration.</p>
</sec>
<sec><title>Design:</title>
<p>Prospective cohort study.</p>
</sec>
<sec><title>Setting:</title>
<p>Tertiary sleep disorders center.</p>
</sec>
<sec><title>Participants:</title>
<p>100 patients with idiopathic RBD, all with diagnosis confirmed on polysomnography, stratified to baseline antidepressant use, with 45 matched controls.</p>
</sec>
<sec><title>Measurements/Results:</title>
<p>Of 100 patients, 27 were taking antidepressants. Compared to matched controls, RBD patients taking antidepressants demonstrated significant abnormalities of 12/14 neurodegenerative markers tested, including olfaction (P = 0.007), color vision (P = 0.004), Unified Parkinson Disease Rating Scale II and III (P < 0.001 and 0.007), timed up-and-go (P = 0.003), alternate tap test (P = 0.002), Purdue Pegboard (P = 0.007), systolic blood pressure drop (P = 0.029), erectile dysfunction (P = 0.002), constipation (P = 0.003), depression indices (P < 0.001), and prevalence of mild cognitive impairment (13% vs. 60%, P < 0.001). All these abnormalities were indistinguishable in severity from RBD patients not taking antidepressants. However, on prospective follow-up, RBD patients taking antidepressants had a lower risk of developing neurodegenerative disease than those without antidepressant use (5-year risk = 22% vs. 59%, RR = 0.22, 95%CI = 0.06, 0.74).</p>
</sec>
<sec><title>Conclusions:</title>
<p>Although patients with antidepressant-associated RBD have a lower risk of neurodegeneration than patients with “purely-idiopathic” RBD, markers of prodromal neurodegeneration are still clearly present. Development of RBD with antidepressants can be an early signal of an underlying neurodegenerative disease.</p>
</sec>
<sec><title>Citation:</title>
<p>Postuma RB; Gagnon JF; Tuineaig M; Bertrand JA; Latreille V; Desjardins C; Montplaisir JY. Antidepressants and REM sleep behavior disorder: isolated side effect or neurodegenerative signal? <italic>SLEEP</italic>
 2013;36(11):1579-1585.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <front><journal-meta><journal-id journal-id-type="nlm-ta">Sleep</journal-id>
<journal-id journal-id-type="iso-abbrev">Sleep</journal-id>
<journal-id journal-id-type="publisher-id">Sleep</journal-id>
<journal-title-group><journal-title>Sleep</journal-title>
</journal-title-group>
<issn pub-type="ppub">0161-8105</issn>
<issn pub-type="epub">1550-9109</issn>
<publisher><publisher-name>Associated Professional Sleep Societies, LLC</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24179289</article-id>
<article-id pub-id-type="pmc">3792373</article-id>
<article-id pub-id-type="doi">10.5665/sleep.3102</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Antidepressants and REM Sleep Behavior Disorder</subject>
</subj-group>
</article-categories>
<title-group><article-title>Antidepressants and REM Sleep Behavior Disorder: Isolated Side Effect or Neurodegenerative Signal?</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Postuma</surname>
<given-names>Ronald B.</given-names>
</name>
<degrees>MD, MSc</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gagnon</surname>
<given-names>Jean-Francois</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tuineaig</surname>
<given-names>Maria</given-names>
</name>
<degrees>BSc</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bertrand</surname>
<given-names>Josie-Anne</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Latreille</surname>
<given-names>Veronique</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Desjardins</surname>
<given-names>Catherine</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Montplaisir</surname>
<given-names>Jacques Y.</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<aff id="aff1"><label>1</label>
Department of Neurology, McGill University, Montreal General Hospital, Montreal, Québec, Canada</aff>
<aff id="aff2"><label>2</label>
Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada</aff>
<aff id="aff3"><label>3</label>
Department of Psychology, Université du Québec à Montréal, Montreal, Québec, Canada</aff>
<aff id="aff4"><label>4</label>
Department of Psychology, Université de Montréal, Montreal, Québec, Canada</aff>
<aff id="aff5"><label>5</label>
Department of Psychiatry, Université de Montréal, Montreal, Québec, Canada</aff>
</contrib-group>
<author-notes><corresp id="cor1">Address correspondence to: Jacques Montplaisir, MD, PhD, <addr-line>CRCPC Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, 5400 Boul. Gouin Ouest, Montréal, Québec, Canada, H4J 1C5</addr-line>
<phone>(514) 338-2693</phone>
<fax>(514) 338-2531</fax>
<email>JY.Montplaisir@UMontreal.CA</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>1</day>
<month>11</month>
<year>2013</year>
</pub-date>
<volume>36</volume>
<issue>11</issue>
<fpage>1579</fpage>
<lpage>1585</lpage>
<history><date date-type="received"><month>2</month>
<year>2013</year>
</date>
<date date-type="rev-recd"><month>4</month>
<year>2013</year>
</date>
<date date-type="accepted"><month>5</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>© 2013 Associated Professional Sleep Societies, LLC.</copyright-statement>
<copyright-year>2013</copyright-year>
</permissions>
<abstract><sec><title>Objectives:</title>
<p>Antidepressants, among the most commonly prescribed medications, trigger symptoms of REM sleep behavior disorder (RBD) in up to 6% of users. Idiopathic RBD is a very strong prodromal marker of Parkinson disease and other synuclein-mediated neurodegenerative syndromes. It is therefore critically important to understand whether antidepressant-associated RBD is an independent pharmacologic syndrome or a sign of possible prodromal neurodegeneration.</p>
</sec>
<sec><title>Design:</title>
<p>Prospective cohort study.</p>
</sec>
<sec><title>Setting:</title>
<p>Tertiary sleep disorders center.</p>
</sec>
<sec><title>Participants:</title>
<p>100 patients with idiopathic RBD, all with diagnosis confirmed on polysomnography, stratified to baseline antidepressant use, with 45 matched controls.</p>
</sec>
<sec><title>Measurements/Results:</title>
<p>Of 100 patients, 27 were taking antidepressants. Compared to matched controls, RBD patients taking antidepressants demonstrated significant abnormalities of 12/14 neurodegenerative markers tested, including olfaction (P = 0.007), color vision (P = 0.004), Unified Parkinson Disease Rating Scale II and III (P < 0.001 and 0.007), timed up-and-go (P = 0.003), alternate tap test (P = 0.002), Purdue Pegboard (P = 0.007), systolic blood pressure drop (P = 0.029), erectile dysfunction (P = 0.002), constipation (P = 0.003), depression indices (P < 0.001), and prevalence of mild cognitive impairment (13% vs. 60%, P < 0.001). All these abnormalities were indistinguishable in severity from RBD patients not taking antidepressants. However, on prospective follow-up, RBD patients taking antidepressants had a lower risk of developing neurodegenerative disease than those without antidepressant use (5-year risk = 22% vs. 59%, RR = 0.22, 95%CI = 0.06, 0.74).</p>
</sec>
<sec><title>Conclusions:</title>
<p>Although patients with antidepressant-associated RBD have a lower risk of neurodegeneration than patients with “purely-idiopathic” RBD, markers of prodromal neurodegeneration are still clearly present. Development of RBD with antidepressants can be an early signal of an underlying neurodegenerative disease.</p>
</sec>
<sec><title>Citation:</title>
<p>Postuma RB; Gagnon JF; Tuineaig M; Bertrand JA; Latreille V; Desjardins C; Montplaisir JY. Antidepressants and REM sleep behavior disorder: isolated side effect or neurodegenerative signal? <italic>SLEEP</italic>
 2013;36(11):1579-1585.</p>
</sec>
</abstract>
<kwd-group><kwd>REM sleep behavior disorder</kwd>
<kwd>antidepressants</kwd>
<kwd>Parkinson disease</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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Antidepressants and REM Sleep Behavior Disorder: Isolated Side Effect or Neurodegenerative Signal?

Antidepressants and REM Sleep Behavior Disorder: Isolated Side Effect or Neurodegenerative Signal?

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Abstract

Links to Exploration step

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