Somnambulism Precipitated by Selective Serotonin-Reuptake Inhibitors

Abstract

Objective: To report a case of somnambulism (sleepwalking) potentially precipitated by selective serotonin-reuptake inhibitors (SSRIs) in an HIV-positive woman. Case Summary: A 34-year-old HIV-positive white woman without a prior history of somnambulism began sleepwalking following treatment for depression with two different SSRIs. The sleepwalking episodes disappeared completely with a reduction of the dosages of the SSRIs and began again when the dosages were increased. Discussion: Somnambulism has been associated with psychoactive drugs that affect the physiology of sleep, awareness, arousal, and memory. A biologic plausibility is supported by the fact that SSRIs alter electroencephalogram and sleep patterns and may be prone to precipitating somnambulism in susceptible individuals. Because people who sleepwalk may not be aware of their actions during such episodes, there is a potential for injury if this adverse effect were to occur. Conclusions: Given the widespread use of SSRIs, clinicians should be aware of the possibility that somnambulism may occur with this class of drugs.