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Sleep in Patients with Schizophrenia or Unipolar or Bipolar Disorder: The Effect of Second-Generation Antipsychotic Drugs

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Sleep and Neuropsychiatric Disorders

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Abstract

In patients with unipolar (depressive) disorder, sleep disturbance generally takes the form of insomnia, whereas patients with bipolar disorder typically show a reduced need for sleep. Sleep impairment in these patients increases the risk for a major depressive episode and suicidal behavior. Insomnia is also a common trait in schizophrenia, with total sleeplessness being frequently detected during acute exacerbation of the psychiatric disease. The effects of a number of second-generation antipsychotic drugs (SGAs) on sleep variables in unipolar and bipolar disorder patients and in patients with schizophrenia have been characterized in sleep laboratories or by home-based sleep recordings. Administration of SGAs to patients with unipolar and bipolar disorder, including clozapine, risperidone, olanzapine, quetiapine, and ziprasidone, have been shown to improve sleep continuity. Additionally, the latter four drugs have been shown to ameliorate disturbed sleep architecture. In various studies of patients with schizophrenia, treatment with clozapine, olanzapine, quetiapine, and paliperidone is typically followed by a significant improvement of sleep induction and continuity in this patient group. Moreover, olanzapine and paliperidone improved sleep architecture. By contrast, quetiapine was associated with increased sleep disruption. No consistent effects were detected during the administration of risperidone. Taken together, this evidence supports the conclusion that several SGAs may ameliorate sleep in patients with schizophrenia and unipolar and bipolar disorder.

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Author information

Authors and Affiliations

  1. Department of Pharmacology and Therapeutics, School of Medicine Clinics Hospital, University of the Republic, Montevideo, Uruguay

    Jaime M. Monti

  2. Somnogen Canada Inc., Toronto, ON, Canada

    S. R. Pandi-Perumal & David Warren Spence

  3. Department of Physiology, School of Medicine, University of the Republic, Montevideo, Uruguay

    Pablo Torterolo

Authors
  1. Jaime M. Monti
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  2. S. R. Pandi-Perumal
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  3. David Warren Spence
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  4. Pablo Torterolo
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Corresponding author

Correspondence to Jaime M. Monti .

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Division of Sleep Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

    Ravi Gupta

  2. Department of Psychiatry, Johns Hopkins Medical School, Baltimore, MD, USA

    David N. Neubauer

  3. Somnogen Canada Inc., Toronto, ON, Canada

    S. R. Pandi-Perumal

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Monti, J.M., Pandi-Perumal, S.R., Spence, D.W., Torterolo, P. (2022). Sleep in Patients with Schizophrenia or Unipolar or Bipolar Disorder: The Effect of Second-Generation Antipsychotic Drugs. In: Gupta, R., Neubauer, D.N., Pandi-Perumal, S.R. (eds) Sleep and Neuropsychiatric Disorders. Springer, Singapore. https://doi.org/10.1007/978-981-16-0123-1_37

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