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Abstract
Although a number of studies have reported sleep disturbances following neuroleptic
withdrawal, a full description of such changes in sleep architecture is not available.
Polysomnographic, plasma prolactin, and clinical measurements were carried out in
a small number of patients on chronic neuroleptic treatment and after drug withdrawal.
Preliminary findings show that in these chronically treated schizophrenic patients
with and without tardive dyskinesia (TD), abrupt neuroleptic withdrawal induces reductions
in total sleep, rapid eye movement (REM) sleep, and plasma prolactin. Furthermore,
an increase in delta sleep was observed only in patients without TD. The REM suppression
occurred significantly earlier in TD patients compared to the non-TD schizophrenic
patients. These changes were transient, and both sleep measures and plasma prolactin
stabilized during the 2–4 weeks after withdrawal to levels somewhere between the values
observed during chronic treatment and withdrawal (week 1) periods. As the withdrawalinduced
exaggerated changes mimicked the dopamine agonist effect on these sleep and hormonal
measures, one can hypothesize that the observed changes are due to unmasking of supersensitive
dopamine receptors following drug cessation. Normalization of these receptors and/or
adaptational changes in other nondopaminergic system(s) can hypothetically explain
the eventual stabilization of these measures during the following weeks.
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Article info
Publication history
Received in revised form:
February 29,
1988
Received:
December 8,
1986
Footnotes
☆Supported in part by NIMH Grants RO3 MH40641-O1, RO1 MH37073-O1A1 and MH35996.
Identification
Copyright
© 1989 Published by Elsevier Inc.
