Yeh Yi-Wei, Chen Chun-Hsiung, Feng Hui-Ming, Wang Sheng-Chiang, Kuo Shin-Chang, Chen Chih-Kang
Department of Psychiatry, Tri-Service General Hospital, Nei-Hu Area, Taipei, Taiwan.
Clin Neuropharmacol. 2009 Jul-Aug;32(4):232-3. doi: 10.1097/WNF.0b013e318187bafc.
Somnambulism consists of variously complex behaviors that may result in harm to self or to others. Many different medications have been reported to induce somnambulism, and a few of them are newer antidepressants. A 40-year-old woman with history of major depression who experienced new onset somnambulism for successive 3 nights, whereas the antidepressant mirtazapine was increased from 30 to 45 mg/d. The notable and complex sleepwalking symptoms terminated dramatically on the first night after withdrawal of mirtazapine. There is clearly a cause-and-effect relationship between the treatment of higher-dosage mirtazapine and development of somnambulism. It might be related to the different affinities to 5-hydroxytryptamine 2 (5-HT(2)) and H(1) receptors at different dosages of mirtazapine, which explain the patient experiencing sleepwalking episodes exclusively at higher doses of mirtazapine. Clinical physicians should be aware of this adverse effect and taper or discontinue the regimen if sleepwalking develops.
梦游症由各种复杂行为组成，这些行为可能会对自身或他人造成伤害。据报道，许多不同的药物会诱发梦游症，其中一些是新型抗抑郁药。一名40岁有重度抑郁症病史的女性连续3晚出现新发梦游症，而抗抑郁药米氮平的剂量从30毫克/天增加到了45毫克/天。在停用米氮平后的第一个晚上，显著且复杂的梦游症状就戏剧性地消失了。高剂量米氮平治疗与梦游症的发生之间显然存在因果关系。这可能与米氮平不同剂量对5-羟色胺2（5-HT(2)）和H(1)受体的不同亲和力有关，这解释了患者仅在高剂量米氮平时出现梦游发作的原因。临床医生应意识到这种不良反应，如果出现梦游症，应逐渐减少剂量或停药。
