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Will Your Antidepressant Lead You to Act Out Dreams?

Sertraline could cause vivid or frightening dreams without the muscles being inactivated, so that a sleeper might act out dreams in a dangerous way.

When you imagine someone sleeping, chances are that the picture is very peaceful-head on the pillow, eyes closed, body relaxed. Now imagine this person dreaming. You can see their eyes moving back and forth under the eyelids. But in most circumstances, the dreamer is not actively moving about. It is unusual for someone to act out dreams.

 Sertraline Led Reader to Act Out Dreams:

Q. I found that the antidepressant sertraline caused very vivid dreams and resulted in my “acting out” aggressively in my sleep. One time I punched my bedside fan. Another time I dove out of bed and hurt myself.

When the medication was discontinued, these vivid dreams stopped and I no longer had the urge to act out dreams. I think others should know about this reaction.

A. Normally during dreams (rapid eye movement, or REM, sleep), our muscles go completely limp. This inability to move the muscles is called “atonia.”

REM Sleep Without Atonia:

Scientists have found that sertraline (Zoloft) can trigger REM sleep without atonia (Progress in Neuro-Psychopharmacology & Biological Psychiatry, Dec. 2, 2013).  This could lead to dream enactment behavior, a tendency to act out dreams.

As you have noticed, this can be pretty dangerous. Sertraline and many other antidepressants can trigger this condition, which can be just as terrible for a bed partner as for the sleeper him- or herself.

Insomnia and abnormal dreams have also been reported as side effects. Sertraline is listed along with dozens of other drugs that may cause insomnia and disrupt rest in our Guide to Getting a Good Night’s Sleep.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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