Posted by Elizabeth on May 7, 2001, at 7:20:02
In reply to pharmacological suppression of nightmares, posted by mila on May 6, 2001, at 16:12:04
Some other pharmacological approaches that I've heard of (most, if not all, are known REM suppressors):
amphetamine and some related drugs (e.g., Ritalin)
anticholinergics (this category includes many antihistamines, tricyclics (especially amitriptyline), as well as drugs like Cogentin and Artane)
benzodiazepines
clonidine
valproateMost effective antinarcolepsy drugs are REM suppressors (Provigil is an exception). If medication is required for children with primary nightmare disorder (i.e., not secondary to PTSD or some such), I think the usual treatment is benzodiazepines (Klonopin is a good choice but higher doses may be required).
I'd avoid SSRIs for antidepressant withdrawal nightmares, as SSRIs can cause nightmares (either as a side effect, or when you try to withdraw from the SSRI). Although they do decrease the total time spent in REM sleep, SSRIs increase REM *density*, which can lead to vivid dreams. On the other hand, because your problem seems to result from withdrawal of Effexor, Prozac might be beneficial (it does not need to be taken at bedtime). Other SSRIs (which have much shorter elimination half-lives) are quite likely to cause a repeat of the REM rebound upon discontinuation.
MAOIs are very powerful REM suppressors (IMHO they would be an excellent choice for PTSD), but they cause REM rebound on withdrawal as well. (In my own experience, this just consists of weird, vivid dreams, but if you're predisposed to nightmares it could be really bad.)
poster:Elizabeth
thread:61779
URL: http://www.dr-bob.org/babble/20010507/msgs/61850.html