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. 2022 Dec 1;18(12):2829-2836.
doi: 10.5664/jcsm.10242.

Trazodone affects periodic leg movements and chin muscle tone during sleep less than selective serotonin reuptake inhibitor antidepressants in children

Lourdes M DelRosso  1 , Maria P Mogavero  2   3 , Oliviero Bruni  4 , Carlos H Schenck  5 , Amy Fickenscher  1 , Raffaele Ferri  6
Affiliations

Trazodone affects periodic leg movements and chin muscle tone during sleep less than selective serotonin reuptake inhibitor antidepressants in children

Lourdes M DelRosso et al. J Clin Sleep Med. .

Abstract

Study objectives: To test the hypothesis that children taking trazodone have less leg movements during sleep (LMS) and higher rapid eye movement (REM) sleep atonia than children taking selective serotonin reuptake inhibitors (SSRIs) but more than normal controls.

Methods: Fifteen children (9 girls and 6 boys, mean age 11.7 years, standard deviation [SD] 3.42) taking trazodone (median dosage 50 mg/d, range 25-200 mg) for insomnia and 19 children (11 girls and 8 boys, mean age 13.7 years, SD 3.07) taking SSRIs for depression, anxiety, or both were consecutively recruited, as well as an age- and sex-matched group of 25 control children (17 girls and 8 boys, mean age 13.7 years, SD 3.11). LMS were scored and a series of parameters was calculated, along with the analysis of their time structure. The Atonia Index was then computed for each non-REM sleep stage and for REM sleep.

Results: Children taking trazodone exhibited slightly higher leg movement indices than controls but lower than those found in children taking SSRIs and their time structure was different. Chin electromyogram atonia in all sleep stages was not significantly altered in children taking trazodone but was decreased in children taking SSRIs, especially during non-REM sleep.

Conclusions: In children, SSRIs but not trazodone are associated with a significantly increased number of LMS, including periodic LMS, and increased chin tone in all sleep stages. The assessment of periodic limb movement disorder and REM sleep without atonia might not be accurate when children are taking SSRIs because of their significant impact.

Citation: DelRosso LM, Mogavero MP, Bruni O, Schenck CH, Fickenscher A, Ferri R. Trazodone affects periodic leg movements and chin muscle tone during sleep less than selective serotonin reuptake inhibitor antidepressants in children. J Clin Sleep Med. 2022;18(12):2829-2836.

Keywords: REM sleep without atonia; SSRI antidepressants; atonia index; children; chin EMG tone; leg movement activity during sleep; periodic leg movements during sleep; trazodone.

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Conflict of interest statement

All authors have seen and approved the manuscript. The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Distribution of intervals between consecutive leg movements during sleep in children taking trazodone or SSRIs and controls.
Data are shown as mean (circles, squares, and diamonds) and standard errors (whiskers). The H2,59 values obtained with the Kruskal-Wallis ANOVA, comparing the 3 groups and computed for all points of the graphs, are shown at the top, along with their significance level (P value). ANOVA = analysis of variance, SSRI = selective serotonin reuptake inhibitor.
Figure 2
Figure 2. Number of PLMS recorded during the first 8 hours of sleep in children taking trazodone or SSRIs and controls.
Data are shown as mean (circles, squares, and diamonds) and standard errors (whiskers). The P values obtained with the Kruskal-Wallis ANOVA, comparing the 3 groups and computed for all points of the graphs, are also shown. ANOVA = analysis of variance, NS = nonsignificant, PLMS = periodic limb movements of sleep, SSRI = selective serotonin reuptake inhibitor.
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References

    1. Ghandour RM , Sherman LJ , Vladutiu CJ , et al. . Prevalence and treatment of depression, anxiety, and conduct problems in US children . J Pediatr. 2019. ; 206 : 256 – 267.e3 . - PMC - PubMed
    1. Dwyer JB , Bloch MH . Antidepressants for pediatric patients . Curr Psychiatr. 2019. ; 18 ( 9 ): 26 – 42F . - PMC - PubMed
    1. Khouzam HR . A review of trazodone use in psychiatric and medical conditions . Postgrad Med. 2017. ; 129 ( 1 ): 140 – 148 . - PubMed
    1. Marek GJ , McDougle CJ , Price LH , Seiden LS . A comparison of trazodone and fluoxetine: implications for a serotonergic mechanism of antidepressant action . Psychopharmacology (Berl). 1992. ; 109 ( 1-2 ): 2 – 11 . - PubMed
    1. Oggianu L , Ke AB , Chetty M , et al. . Estimation of an appropriate dose of trazodone for pediatric insomnia and the potential for a trazodone-atomoxetine interaction . CPT Pharmacometrics Syst Pharmacol. 2020. ; 9 ( 2 ): 77 – 86 . - PMC - PubMed