title: Ramelteon-induced nightmares: A case report.
abstract: Ramelteon is the only FDA-approved melatonin agonist for treatment of insomnia. It acts on melatonin MT1 and MT2 receptors. We describe a case of a patient who was prescribed ramelteon for insomnia disorder. Shortly after initiation of ramelteon, he described vivid nightmares leading to discontinuation of ramelteon. The nightmares ameliorated with ramelteon discontinuation. Ramelteon is well tolerated with a favorable side-effect profile. No documented cases of nightmares secondary to ramelteon use were found in the literature. The effects of ramelteon on rapid eye movement sleep, the stage of sleep where dreams occur, need to be further explored.
authors.affiliation: Department of Psychiatry & Behavioral Medicine, Carilion Clinic-Virginia Tech Carilion, First Floor Administrative Suites, 2017 South Jefferson Street, Roanoke 24014, VA, United States. Electronic address: shahc@upmc.edu.
authors.forename: Chintan
authors.initials: C
authors.lastname: Shah
authors.affiliation: Department of Psychiatry & Behavioral Medicine, Carilion Clinic-Virginia Tech Carilion, First Floor Administrative Suites, 2017 South Jefferson Street, Roanoke 24014, VA, United States.
authors.forename: Anita
authors.initials: A
authors.lastname: Kablinger
mesh_terms: D000328:Adult; D000662:Amphetamines / Q000008:administration & dosage*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D004325:Dreams / Q000187:drug effects*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007192:Indenes / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D044094:Receptors, Melatonin / Q000037:antagonists & inhibitors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology
chemical_list: C090411:Adderall; D000662:Amphetamines; D000697:Central Nervous System Stimulants; D006993:Hypnotics and Sedatives; D007192:Indenes; D044094:Receptors, Melatonin; C495910:ramelteon
keywords: Dreams; Nightmares; Ramelteon