SSRIs Linked To Periodic Limb Movements of Sleep In Children

<"">Selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Celexa, Zoloft, and Lexapro, have long been linked to an array of adverse reactions, including in the developing fetus. Now, an emerging study revealed that children taking SSRIs experience a five-fold increased risk for periodic limb movements of sleep, versus children who do not take SSRIs, said Family Practice News.

The retrospective study reviewed polysomnography data and found that 31.7% of 41 children taking SSRIs experienced periodic limb movements of sleep versus just 7.8% of 982 children not taking SSRIs, a 5.45 odds ratio, according to study lead, Dr. Martina Vendrame, of Boston University and her team, said Family Practice News. The research also revealed that the median periodic limb movement index in children taking SSRIs was significantly higher versus children not taking SSRIs (11.2 vs. 6.5), the team said.

This study is just one of a few on children and teens concerning SSRIs and periodic limb movements; however, the phenomenon has been seen in adult studies involving serotonergic antidepressants, said Family Practice News. As a matter-of-fact, one study revealed that 44% of adults taking fluoxetine (Prozac, Rapiflux, Sarafem, Selfemra) experienced symptoms, while others showed a worsening of restless legs syndrome (RLS) in up to 10% of adult SSRI patients, noted Family Practice News.

The children involved in the study underwent overnight diagnostic polysomnography at one center from January 2009 to April 2010, with studies conducted for sleep problems including snoring, breathing pauses, daytime sleepiness, and gasping or snorting when sleeping, said Family Practice News. No study was specifically conducted for RLS or periodic limb movements of sleep. SSRI patients included 31 girls and 10 boys with a median age of 15.4 years. Medications were prescribed for depression: Celexa (citalopram) or Lexapro (escitalopram) (15 patients), fluoxetine (14 patients), and Zoloft (sertraline) (12 patients).

“The mechanism by which SSRIs may cause periodic limb movements of sleep is not clear, but serotonin-mediated dopaminergic inhibition may represent the underlying mechanism,” the investigators wrote, reported Family Practice News. The team suggested a thorough history be conducted to assess if SSRIs cause sleep disturbance and if the child experiences RLS, said Family Practice News. “If necessary, the use of antidepressants not associated with periodic limb movements of sleep should be considered,” they added.

Dr. Brian Murray, director of integrated medical education for the department of medicine at the University of Toronto and associate professor of neurology and sleep medicine at Toronto’s Sunnybrook Health Sciences Center, wrote an accompanying piece to the Family Practice report. Calling for more study, Dr. Murray noted that periodic limb movements of sleep are often seen in RLS, which can be confused with other pediatric issues, such as “growing pains” and that periodic limb movements of sleep have been suggested as a link to increased risks for cardiovascular disease.

Meanwhile, we recently wrote that a new study added autism to the possible risks associated with the use of SSRIs such as Prozac, Luvox, Paxil, Celexa, and Zoloft during pregnancy. The study also found a higher risk of other birth defects, including neural tube birth defects. Fetal alcohol spectrum disorders were also 10-times more common in the SSRI-exposed group compared to those not exposed, the study said.

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