SSRI treatment suppresses dream recall frequency but increases subjective dream intensity in normal subjects.
Edward F Pace-Schott, T Gersh, R Silvestri, Robert Stickgold, C Salzman, J A Hobson
Journal of Sleep Research June 1, 2001 DOI: 10.1046/j.1365-2869.2001.00249.x (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 14 |
| Population | Healthy volunteers free of medical or neuropsychiatric symptoms and psychotropic or sleep-affecting drugs |
| Interventions | Fluvoxamine Paroxetine |
| Dose | 100 mg fluvoxamine or 20 mg paroxetine daily in divided doses |
| Duration | 31 days: 7-day baseline, 19 days treatment, 5 days acute discontinuation |
| Measures | Dream report length, bizarreness, movement, number of visual nouns, subjective dream intensity, dream recall frequency, REM sleep measures |
| Topics | Dreaming |
| Keywords | Non-programmatic |
| Key findings | Dream recall frequency decreased during SSRI treatment, while subjective dream intensity increased during both treatment and acute discontinuation; dream report length and bizarreness increased during acute discontinuation, especially with fluvoxamine. |
Abstract
Clinical lore and a small number of published studies report that the selective serotonin reuptake inhibitors (SSRIs) intensify dreaming. This study examines the dream effects of paroxetine and fluvoxamine in order to both increase clinical knowledge of these agents and to test an important potential method for probing the relationship between REM sleep neurobiology and dreaming in humans. Fourteen normal, paid volunteers (4 males, 10 females; mean age 27.4 year, range 22--39) free of medical or neuropsychiatric symptoms as well as of psychotropic or sleep affecting drugs completed a 31-day home-based study consisting of: 7 days drug-free baseline; 19 days on either 100 mg fluvoxamine (7 Ss) or 20 mg paroxetine (7 Ss) in divided morning and evening doses; and 5 days acute discontinuation. Upon awakening, subjects wrote dream reports, self-scored specific emotions in their reports and rated seven general dream characteristics using 5-point Likert scales. Dream reports were independently scored for bizarreness, movement and number of visual nouns by three judges. REM sleep-related measures were obtained using the Nightcap ambulatory sleep monitor. Mean dream recall frequency decreased during treatment compared with baseline. Dream report length and judge-rated bizarreness were greater during acute discontinuation compared with both baseline and treatment and this effect was a result of the fluvoxamine-treated subjects. The subjective intensity of dreaming increased during both treatment and acute discontinuation compared with baseline. Propensity to enter REM sleep was decreased during treatment compared with baseline and acute discontinuation and the intensity of REM sleep increased during acute discontinuation compared with baseline and treatment. The decrease in dream frequency during SSRI treatment may reflect serotonergic REM suppression while the augmented report length and bizarreness during acute SSRI discontinuation may reflect cholinergic rebound from serotonergic suppression.
Comparable studies
Other observational and cohort studies on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Lucid Dreaming: a State of Consciousness with Features of Both Waking and Non-Lucid Dreaming Student volunteers trained to become lucid and signal lucidity with horizontal eye... | 2009 | Observational study | n = 6 |
| Nightmare Prevalence, Nightmare Distress, and Self-Reported Psychological Disturbance Young adults with a mean age of 20 years | 2002 | Prospective observational study | n = 116 |
| Long-term effects of extreme situational stress on sleep and dreaming Survivors of traumatic events who complained of sleep disturbances, compared with... | 1987 | Case-control study | n = 11 |
| The relationship of nightmare frequency and nightmare distress to well‐being Adults who reported dreams | 2004 | Observational cohort | n = 147 |
| The prevalence of nightmares and their independence from anxiety. Undergraduates | 1990 | Observational study using daily dream logs | n = 220 |
Citations in the library
Cited by 20
- Nightmares and bad dreams in patients with borderline personality disorder: Fantasy as a coping skill? The European Journal of Psychiatry March 1, 2010
- Serotonin and dreaming Birkhäuser Basel eBooks March 3, 2008
- Dream Recall Frequency Among Patients in a Psychiatric Outpatient Clinic in Ile-Ife, Nigeria Libyan Journal of Medicine 2009
- Dronabinol for nightmares in post-traumatic stress disorder: a randomized controlled trial. Nature Medicine September 2026
- Behind closed eyes: Understanding nightmares in children and adolescents with autism spectrum disorder - A systematic review. Neuroscience & Biobehavioral Reviews January 14, 2025
and 15 more in the library
Cites 3
- Intrinsic dreams are not produced without REM sleep mechanisms: evidence through elicitation of sleep onset REM periods Journal of Sleep Research March 4, 2001
- Drug-induced nightmares. Annals of Pharmacotherapy 1999
- Consciousness in waking and dreaming: the roles of neuronal oscillation and neuromodulation in determining similarities and differences. Neuroscience May 1997