Hypnic jerks possibly induced by escitalopram

Hypnic Jerks, Major Depressive Disorder, and Antidepressant Use: A Possible Relationship

The term hypnic jerks (also known as sleep starts or hypnagogic jerks) refers to a physiological phenomenon that accompanies sleep-wake transitions and can occur in healthy individuals of any age. Various physiological and stressful stimuli can precipitate hypnic jerks and contribute to their frequency and amplitude, e.g., stress, fatigue, stimulants like caffeine, and certain medications. Hypnic jerks are usually benign, but they can be intensified in certain situations, interfering with sleep onset and causing insomnia. Here we reported the case of a patient who suffered from intensified hypnic jerks that led to the development of major depressive disorder. Although the depressive symptoms improved on escitalopram 20 mg, the hypnic jerks increased significantly. Clonazepam was found to be very effective in reducing the hypnic jerks and stabilizing his condition.

SSRI induced hypnic jerks: A case series

A hypnic jerk is an abrupt, involuntary, nonrepetitive contraction of muscles of the body that occurs during the onset of sleep in stage 1 of nonrapid eye movement sleep. Various physiological and stressful stimuli can precipitate hypnic jerks with no further neurological sequelae. Although selective serotonin reuptake inhibitor (SSRI) medications are well known to disturb the normal sleep cycle and cause rapid eye movement sleep behavioral disorders, there were only a few case reports of them causing hypnic jerks and those were reported due to Escitalopram only. Here is a case series of four cases of hypnic jerks found to be associated with the use of various SSRIs, Escitalopram, Sertraline, and Fluoxetine. Clonazepam was found to be very effective in reducing the hypnic jerks associated with SSRIs. In all the cases, the sleep-induced Electroencephalogram was normal.