Medication induced sleepwalking

Abstract

Sleepwalking (somnambulism, noctambulism) is a form of parasomnia associated with non-REM sleep, which is characterized by the presence of recurring episodes of sleep-congruent simple or complex behavioral manifestations upon awakening from non-REM sleep. Causes of sleepwalking include increased excitability during non-REM sleep, sleep deprivation, a decrease in the severity of inhibitory processes against the background of defects in GABAergic inhibitory influences and suppression of cholinergic neuronal activation. In adulthood, somnambulism is malignant in nature, and can lead to various adverse consequences. Some of the drugs can cause the development of sleepwalking, in addition, in some cases, the drugs that are used to treat this condition can themselves provoke sleepwalking, such conditions are called drug-induced (DI) sleepwalking. To date, about 30 drugs have been verified, the use of which is associated with the occurrence of sleepwalking, primarily benzodiazepine receptor agonists, atypical antipsychotics, antidepressants and other serotonergic drugs, as well as β-blockers. Risk factors for the development of DI sleepwalking include a history of sleepwalking episodes, the combined use of 2 or more drugs that can provoke its development, and the combined use of potential inducer drugs with alcohol. Treatment includes withdrawal of the inducer drug, cognitive behavioral therapy, and psychopharmacotherapy.