Dreaming under antidepressants: a systematic review on evidence in depressive patients and healthy volunteers.
Gotthard G. Tribl, Thomas C. Wetter, Michael Schredl
Sleep Medicine Reviews April 1, 2013 DOI: 10.1016/j.smrv.2012.05.001 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Depressive patients and healthy volunteers |
| Topics | Dreaming |
| Key findings | Antidepressants decrease dream recall frequency, with tricyclic antidepressants and phenelzine showing a consistent effect and SSRIs/SNRIs a less consistent one. |
Abstract
Sleep related symptoms of depression include sleep fragmentation, early morning awakening, decreased rapid eye movement (REM) sleep latency, increased REM density, and more negative dream content. Most tricyclic antidepressants (ADs) increase total sleep time and decrease wake time after sleep onset, while many selective serotonin reuptake inhibitors (SSRIs) have an opposite effect. However, almost all ADs prolong REM sleep latency and reduce the amount of REM sleep. Case reports and research data indicate a strong effect of ADs on dream recall and dream content. We performed a systematic review (1950 to August 2010) about ADs impact on dreaming in depressive patients and healthy volunteers. Twenty-one clinical studies and 25 case reports were eligible for review and document a clear AD effect on dreaming. The major finding, both in depressed patients and in healthy volunteers, is a decrease of dream recall frequency (DRF) under ADs. This is a rather consistent effect in tricyclic ADs and phenelzine, less consistently documented also for SSRIs/serotonin norepinephrine reuptake inhibitors (SNRIs). Tricyclic ADs induce more positive dream emotions. Withdrawal from tricyclic ADs and from the monoamine oxidase inhibitors phenelzine and tranylcypromine may cause nightmares. Intake and even more withdrawal of SSRIs/SNRIs seem to intensify dreaming, which may be experienced in different ways; a potential to cause nightmares has to be taken into account. Though there are clear-cut pharmacological effects of ADs on DRF and dream content, publications have been surprisingly scarce during the past 60 years. There is evidence of a gap in neuropsychopharmacological research. AD effects on dreams should be recognized and may be used in treatment.
Comparable studies
Other systematic reviews and meta-analyses on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Dreaming as mind wandering: evidence from functional neuroimaging and first-person content reports. | 2013 | Systematic review with meta-analytic comparison | |
| Lucid dreaming incidence: A quality effects meta-analysis of 50 years of research | 2016 | Meta-analysis | |
| The effectiveness of lucid dreaming therapy in patients with nightmares: A systematic review. Adults with chronic and recurring nightmares | 2023 | Systematic review | |
| The relationships between insomnia, nightmares, and dreams: A systematic review Individuals without a concomitant psychopathology, including those with insomnia or... | 2024 | Systematic review | |
| Psychosocial treatments for nightmares in adults and children: a systematic review | 2023 | Systematic review |
Citations in the library
Cited by 24
- Importance of Integrating Spiritual, Existential, Religious, and Theological Components in Psychedelic-Assisted Therapies. JAMA Psychiatry July 1, 2023
- Nightmares in Patients with Psychosis: The Relation with Sleep, Psychotic, Affective, and Cognitive Symptoms The Canadian Journal of Psychiatry August 1, 2015
- Continuity between waking life and dreams of psychiatric patients A review and discussion of the implications for dream research University Library Heidelberg 2014
- Psychosocial treatments for nightmares in adults and children: a systematic review BMC Psychiatry April 21, 2023
- Sleep, Nightmares and Schizophrenia Journal of Sleep Disorders and Management November 3, 2017
and 19 more in the library
Cites 9
- Questionnaires and diaries as research instruments in dream research: Methodological issues. Dreaming March 1, 2002
- Serotonin and dreaming Birkhäuser Basel eBooks March 3, 2008
- Acute Psychosis Associated with Dissociated Sleep‐Wakefulness State After Mirtazapine Treatment Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy March 24, 2010
- REM sleep and dreaming: towards a theory of protoconsciousness. Nature Reviews Neuroscience November 2009
- The effect of trimipramine on dream recall and dream emotions in depressive outpatients. Psychiatry Research May 30, 2009
and 4 more in the library