Sleep Research & Clinical Chronobiology, Department of Physiology-CBF, Charité-Universitätsmedizin, Berlin, Germany.
Pharmacopsychiatry. 2013 May;46(3):108-13. doi: 10.1055/s-0032-1331702. Epub 2013 Jan 4.
Many antidepressants are associated with periodic limb movements (PLM) during sleep. Although some tricyclic antidepressants, such as amitriptyline, promote sleep and are thus often prescribed as a treatment for sleep disturbances that can accompany depression, it remains unclear whether amitriptyline is associated with PLM.
32 healthy males (18-39 years) spent 2 consecutive nights in the sleep lab for polysomnographic recording. During the second night, they received either 75 mg amitriptyline or placebo in a randomized, double-blind, placebo-controlled manner.
In subjects receiving amitriptyline but not in subjects receiving placebo, the number of periodic leg movements per h was significantly increased from baseline to intervention night. However, objective polysomnographic sleep parameters (such as the number of awakenings, wake after sleep onset, and sleep efficiency) and subjective sleep perception were not significantly associated with any PLM indices.
Our findings indicate that amitriptyline can induce or even increase the number of PLM during sleep in healthy subjects. When treating sleep disturbances with amitriptyline, PLM should be considered as a possible cause of insufficient improvement.
许多抗抑郁药会导致睡眠期间出现周期性肢体运动（PLM）。虽然一些三环类抗抑郁药，如阿米替林，可促进睡眠，因此常被开处方用于治疗可能伴随抑郁的睡眠障碍，但阿米替林是否与 PLM 有关仍不清楚。
32 名健康男性（18-39 岁）连续两晚在睡眠实验室进行多导睡眠图记录。在第二晚，他们以随机、双盲、安慰剂对照的方式接受 75 毫克阿米替林或安慰剂。
在服用阿米替林的受试者中，但在服用安慰剂的受试者中，周期性腿部运动的次数从基线到干预夜显著增加。然而，客观的多导睡眠图睡眠参数（如觉醒次数、睡眠起始后觉醒和睡眠效率）和主观睡眠感知与任何 PLM 指数均无显著相关性。
我们的发现表明，阿米替林可在健康受试者中诱导甚至增加睡眠期间的 PLM 数量。当用阿米替林治疗睡眠障碍时，应将 PLM 视为改善不足的可能原因。
