Anticholinergic drugs sleep

Anticholinergic Drugs on Human REM Sleep and Nocturnal Penile Tumescence. Waking Sleeping 3 81. 

Safer, D.J. 1969 The Concomitant Effects of Mild Sleep Loss and Anticholinergic Drug. Edgewood Arsenal Technical Report 4268. 

Much more common are such sjmptoms as confusion (13% of cases), depression (9% of cases, often requiring antidepressant drugs), and sleep disturbances (20% of cases). Vivid hallucinations are common. Psychotic sjmptoms appear to be more common when enzyme inhibitors are used or anticholinergic drugs given. Panic attacks seem to occur in some 20% of cases during the off phases of an off/on cycle (38). 

As the name implies, all of the SSRIs block the reuptake of serotonin, but not norepinephrine. Some, like fluoxetine (Prozac), are relatively free of anticholinergic properties, whereas others (e.g., paroxetine, known as Paxil) are as anticholinergic as some of the tricyclics. Unfortunately, all of these new drugs disrupt sleep at least as much as their predecessors and do so in a distinctive and problematic way that warrants our close scrutiny. 

MAO Inhibitors. In contrast to the tricyclics, MAO inhibitors tend to produce CNS excitation, which can result in restlessness, irritability, agitation, and sleep loss. These drugs also produce some central and peripheral anticholinergic effects (e.g., tremor, confusion, dry mouth, urinary retention), but these effects tend to occur in a lesser extent than with the tricyclics (see Table 7-3). Because of the systemic MAO inhibition, excess activity at peripheral sympathetic adrenergic terminals may cause a profound increase in blood pressure, leading to a hypertensive crisis. This situation is exacerbated if other drugs that increase sympathetic nervous activity are being taken... 

Drugs reported to affect aqueous tear secretion are listed in Table 35-6. Among the agents that frequently reduce tear secretion are the anticholinergics and antihistamines. These classes of drugs are also present in numerous over-the-counter products such as sedatives, sleep aids, cold preparations, antidiarrheals, and nasal decongestants. 

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