Abstract
OBJECTIVE: To investigate the effects of a newer antipsychotic drug, risperidone (a potent serotonin 5-HT2A/2C and dopamine D2-receptor blocker), on the quantity and quality of sleep in patients with schizophrenia. DESIGN: Prospective pilot study. SETTING: Outpatient treatment at a mental health hospital. PATIENTS: Two groups of age- and sex-matched patients with schizophrenia receiving either risperidone (n = 8) or a typical antipsychotic drug (n = 8), and a group of age- and sex-matched controls (n = 8). OUTCOME MEASURES: Sleep quality, measured by a visual analogue scale, and sleep continuity, measured using a movement index calculated from actigraph data. RESULTS: Patients with schizophrenia had more disturbed sleep than controls. Compared with patients treated with typical antipsychotic drugs, patients treated with risperidone reported significantly better sleep quantity and quality as well as general functioning. CONCLUSION: Improvement by risperidone may be related to 5-HT2A/2C receptor blockade; however, further controlled studies are required to confirm these results.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Caldwell D. F., Domino E. F. Electroencephalographic and eye movement patterns during sleep in chronic schizophrenic patients. Electroencephalogr Clin Neurophysiol. 1967 May;22(5):414–420. doi: 10.1016/0013-4694(67)90168-x. [DOI] [PubMed] [Google Scholar]
- Daniel D. G., Goldberg T. E., Weinberger D. R., Kleinman J. E., Pickar D., Lubick L. J., Williams T. S. Different side effect profiles of risperidone and clozapine in 20 outpatients with schizophrenia or schizoaffective disorder: a pilot study. Am J Psychiatry. 1996 Mar;153(3):417–419. doi: 10.1176/ajp.153.3.417. [DOI] [PubMed] [Google Scholar]
- Dugovic C., Wauquier A., Janssen P. A. Differential effects of the new antipsychotic risperidone on sleep and wakefulness in the rat. Neuropharmacology. 1989 Dec;28(12):1431–1433. doi: 10.1016/0028-3908(89)90023-3. [DOI] [PubMed] [Google Scholar]
- Duka T., Goerke D., Fichte K. Effects of ZK 93,426, a beta-carboline benzodiazepine receptor antagonist on night sleep pattern in healthy male volunteers. Psychopharmacology (Berl) 1995 Jan;117(2):178–185. doi: 10.1007/BF02245185. [DOI] [PubMed] [Google Scholar]
- Endicott J., Spitzer R. L., Fleiss J. L., Cohen J. The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry. 1976 Jun;33(6):766–771. doi: 10.1001/archpsyc.1976.01770060086012. [DOI] [PubMed] [Google Scholar]
- Feinberg I., Braun M., Koresko R. L., Gottlieb F. Stage 4 sleep in schizophrenia. Arch Gen Psychiatry. 1969 Sep;21(3):262–266. doi: 10.1001/archpsyc.1969.01740210006002. [DOI] [PubMed] [Google Scholar]
- Gillberg M., Kecklund G., Akerstedt T. Relations between performance and subjective ratings of sleepiness during a night awake. Sleep. 1994 Apr;17(3):236–241. doi: 10.1093/sleep/17.3.236. [DOI] [PubMed] [Google Scholar]
- Herdman J. R., Cowen P. J., Campling G. M., Hockney R. A., Laver D., Sharpley A. L. Effect of lofepramine on 5-HT function and sleep. J Affect Disord. 1993 Sep;29(1):63–72. doi: 10.1016/0165-0327(93)90121-y. [DOI] [PubMed] [Google Scholar]
- Hiatt J. F., Floyd T. C., Katz P. H., Feinberg I. Further evidence of abnormal non-rapid-eye-movement sleep in schizophrenia. Arch Gen Psychiatry. 1985 Aug;42(8):797–802. doi: 10.1001/archpsyc.1985.01790310059007. [DOI] [PubMed] [Google Scholar]
- Jacobsen F. M. Risperidone in the treatment of affective illness and obsessive-compulsive disorder. J Clin Psychiatry. 1995 Sep;56(9):423–429. [PubMed] [Google Scholar]
- Janssen P. A., Niemegeers C. J., Awouters F., Schellekens K. H., Megens A. A., Meert T. F. Pharmacology of risperidone (R 64 766), a new antipsychotic with serotonin-S2 and dopamine-D2 antagonistic properties. J Pharmacol Exp Ther. 1988 Feb;244(2):685–693. [PubMed] [Google Scholar]
- Jus K., Bouchard M., Jus A. K., Villeneuve A., Lachance R. Sleep EEG studies in untreated, long-term schizophrenic patients. Arch Gen Psychiatry. 1973 Sep;29(3):386–390. doi: 10.1001/archpsyc.1973.04200030074011. [DOI] [PubMed] [Google Scholar]
- Kerwin R. W. The new atypical antipsychotics. A lack of extrapyramidal side-effects and new routes in schizophrenia research. Br J Psychiatry. 1994 Feb;164(2):141–148. doi: 10.1192/bjp.164.2.141. [DOI] [PubMed] [Google Scholar]
- Naiman J., Poitras R., Engelsmann F. Effect of chlorpromazine on REM rebound in normal volunteers. Can Psychiatr Assoc J. 1972 Dec;17(6):463–469. doi: 10.1177/070674377201700612. [DOI] [PubMed] [Google Scholar]
- Sadeh A., Hauri P. J., Kripke D. F., Lavie P. The role of actigraphy in the evaluation of sleep disorders. Sleep. 1995 May;18(4):288–302. doi: 10.1093/sleep/18.4.288. [DOI] [PubMed] [Google Scholar]
- Saletu B., Klösch G., Gruber G., Anderer P., Udomratn P., Frey R. First-night-effects on generalized anxiety disorder (GAD)-based insomnia: laboratory versus home sleep recordings. Sleep. 1996 Nov;19(9):691–697. [PubMed] [Google Scholar]
- Sharpley A. L., Cowen P. J. Effect of pharmacologic treatments on the sleep of depressed patients. Biol Psychiatry. 1995 Jan 15;37(2):85–98. doi: 10.1016/0006-3223(94)00135-P. [DOI] [PubMed] [Google Scholar]
- Sharpley A. L., Elliott J. M., Attenburrow M. J., Cowen P. J. Slow wave sleep in humans: role of 5-HT2A and 5-HT2C receptors. Neuropharmacology. 1994 Mar-Apr;33(3-4):467–471. doi: 10.1016/0028-3908(94)90077-9. [DOI] [PubMed] [Google Scholar]
- Takahashi M., Fukuda H., Arito H. Brief naps during post-lunch rest: effects on alertness, performance, and autonomic balance. Eur J Appl Physiol Occup Physiol. 1998 Jul;78(2):93–98. doi: 10.1007/s004210050392. [DOI] [PubMed] [Google Scholar]
- Taylor S. F., Tandon R., Shipley J. E., Eiser A. S. Effect of neuroleptic treatment on polysomnographic measures in schizophrenia. Biol Psychiatry. 1991 Nov 1;30(9):904–912. doi: 10.1016/0006-3223(91)90004-6. [DOI] [PubMed] [Google Scholar]
- Traub A. C. Sleep stage deficits in chronic schizophrenia. Psychol Rep. 1972 Dec;31(3):815–820. doi: 10.2466/pr0.1972.31.3.815. [DOI] [PubMed] [Google Scholar]
- Wetter T. C., Lauer C. J., Gillich G., Pollmächer T. The electroencephalographic sleep pattern in schizophrenic patients treated with clozapine or classical antipsychotic drugs. J Psychiatr Res. 1996 Nov-Dec;30(6):411–419. doi: 10.1016/s0022-3956(96)00022-2. [DOI] [PubMed] [Google Scholar]