Somnambulism (Sleep Walking) Medication

  • Author: Gregory Ackroyd, MD; Chief Editor: Selim R Benbadis, MD   more...
 
Updated: Mar 25, 2010
 

Medication Summary

The goal of pharmacotherapy is to reduce morbidity and to prevent complications. In addition to the agents listed below, up to 6 mg Melatonin may be used at bedtime.

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Tricyclic antidepressants

Class Summary

These agents, comprising a complex group of drugs, have central and peripheral anticholinergic effects and sedative effects. They block the active reuptake of norepinephrine and serotonin.

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Amitriptyline (Elavil)

 

Increases synaptic concentration of serotonin and/or norepinephrine in CNS by inhibiting reuptake at presynaptic neuronal membrane. Useful as analgesic for certain types of chronic and neuropathic pain.

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Nortriptyline (Aventyl HCl, Pamelor)

 

Has demonstrated effectiveness in treatment of chronic pain. Increases synaptic concentration of serotonin and/or norepinephrine in CNS by inhibiting their reuptake by presynaptic neuronal membrane. Additional pharmacodynamic effects such as desensitization of adenyl cyclase and downregulation of beta-adrenergic receptors and serotonin receptors appear to play role.

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Benzodiazepines

Class Summary

A large group of compounds with a benzene ring nucleus fused to a 7-sided diazepine ring. Benzodiazepines bind to specific receptors in association with GABA-binding sites on chloride channels. The frequency of channel opening is increased, increasing flow of chloride ions into neurons. Their relatively high therapeutic index and lower abuse potential than many of other sedative-hypnotics have made them sedative-hypnotic drugs of choice.

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Clonazepam (Klonopin)

 

Believed to enhance activity of inhibitory neurotransmitter GABA in CNS. Antiseizure and antipanic effectiveness has been demonstrated. Generally considered DOC for disorders of arousal.

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Contributor Information and Disclosures
Author

Gregory Ackroyd, MD  Consulting Staff, North Bay Sleep Medicine Institute

Gregory Ackroyd, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, and American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

O'Neill F D'Cruz, MD  Professor, Departments of Neurology and Pediatrics, Director, Pediatric Sleep Program, University of North Carolina

O'Neill F D'Cruz, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Medical Association, Child Neurology Society, and North Carolina Medical Society

Disclosure: Nothing to disclose.

Stephen J Sharp, MD  Assistant Professor of Neurology and Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland

Stephen J Sharp, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, and Child Neurology Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Anthony M Murro, MD  Laboratory Director, Professor, Department of Neurology, Medical College of Georgia

Anthony M Murro, MD is a member of the following medical societies: American Academy of Neurology and American Epilepsy Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Kenneth J Mack, MD, PhD  Senior Associate Consultant, Department of Child and Adolescent Neurology, Mayo Clinic

Kenneth J Mack, MD, PhD is a member of the following medical societies: American Academy of Neurology, Child Neurology Society, Phi Beta Kappa, and Society for Neuroscience

Disclosure: Nothing to disclose.

Chief Editor

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Ortho McNeil Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Speaking, consulting

References

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  15. Rosen GM, Mahowald MW, Ferber R. Sleepwalking, confusional arousals, and sleep terrors in the child. In: Principles and Practice of Sleep Medicine in the Child. 1995:99-106.

  16. Stores G. Practitioner review: assessment and treatment of sleep disorders in children and adolescents. J Child Psychol Psychiatry. Nov 1996;37(8):907-25. [Medline].

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  18. Zucconi M, Oldani A, Ferini-Strambi L, et al. Nocturnal paroxysmal arousals with motor behaviors during sleep: frontal lobe epilepsy or parasomnia?. J Clin Neurophysiol. Nov 1997;14(6):513-22. [Medline].

 
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