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Serotonin and dreaming

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Serotonin and Sleep: Molecular, Functional and Clinical Aspects

Abstract

Many clinical anecdotes and an experimental study have reported intensification of dreaming by the selective serotonin-reuptake inhibitors (SSRIs). However, no published neurochemical dream model invokes serotonin as a dream-promoting neuromodulator or accounts for serotonergic dream enhancement. An experimental study of normal volunteers showed that, although SSRI treatment decreased dream recall frequency, several subject-rated dream-intensity measures were greater during steady-state drug administration compared with pre-drug baseline and early drug treatment. Additionally, such subject-rated dream intensity as well as dream report length and judge-rated bizarreness were greater during acute discontinuation than during pre-drug baseline and drug administration periods. Nightcap ambulatory monitor data showed increased REM latency during treatment and increased REM density during acute discontinuation, indicative of SSRI-induced REM suppression and REM rebound following drug discontinuation, respectively. The bulk of pharmacological evidence suggests that drugs that enhance serotonergic neurotransmission lighten sleep. Sleep-disruptive effects of SSRIs are accompanied by electroencephalographic and electromyographic signs of brain activation, abnormally prominent eye movements in NREM sleep, and REM rebound following drug discontinuation. Explanations of SSRI-induced dream intensification suggested by these findings include, respectively, generalized brain activation during sleep, enhanced NREM dreaming, and within-night REM rebound. Additional clues as to potential causes of serotonergic dream enhancement are provided by: (i) the cellular pharmacology of hallucinogens that act on 5-HT 2A receptors, (ii) the phenomenological and functional neuroimaging effects of serotonergic hallucinogens, and (iii) putative neurophysiological mechanisms of lesionrelated complex hallucinosis.

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Authors and Affiliations

  1. Harvard Medical School, Division of Sleep Medicine, Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02115, USA

    Edward F. Pace-Schott

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Editors and Affiliations

  1. Pharmacology and Therapeutics, School of Medicine, Clinics Hospital, Montevideo, 11300, Uruguay

    Jaime M. Monti

  2. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, College of Physicians and Surgeons of Columbia University, 630 West 168th Street - Rm # BB813, New York, NY, 10032, USA

    S. R. Pandi-Perumal

  3. Green Hall, Program in Neuroscience, Princeton University, Princeton, NJ, 08540, USA

    Barry L. Jacobs

  4. Psychopharmacology Unit, Dorothy Hodgkin Building Whitson Street, Bristol, BS1 3NY, UK

    David J. Nutt

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Pace-Schott, E.F. (2008). Serotonin and dreaming. In: Monti, J.M., Pandi-Perumal, S.R., Jacobs, B.L., Nutt, D.J. (eds) Serotonin and Sleep: Molecular, Functional and Clinical Aspects. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8561-3_12

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