title: New onset somnambulism associated with different dosage of mirtazapine: a case report.
abstract: 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.
authors: Department of Psychiatry, Tri-Service General Hospital, Nei-Hu Area, Taipei, Taiwan.
authors: Yi-Wei
authors: YW
authors: Yeh
authors: Chun-Hsiung
authors: CH
authors: Chen
authors: Hui-Ming
authors: HM
authors: Feng
authors: Sheng-Chiang
authors: SC
authors: Wang
authors: Shin-Chang
authors: SC
authors: Kuo
authors: Chih-Kang
authors: CK
authors: Chen
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives*; D000078785:Mirtazapine; D013009:Somnambulism / Q000139:chemically induced* / Q000523:psychology
chemical_list: D000929:Antidepressive Agents, Tricyclic; D008803:Mianserin; D000078785:Mirtazapine