Skip to main content

Advertisement

Log in

Antipsychotic-Induced Somnolence in Mothers with Schizophrenia

  • Original Paper
  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

Although it is known that many antipsychotic drugs, at the doses prescribed for schizophrenia, are sedative and cause daytime drowsiness, the effect of potentially diminished vigilance on parenting parameters has not been studied. The aim of this paper is to advise clinicians about sedative load in mothers who are prescribed antipsychotic medication. A Medline search was conducted into the sedative effects of antipsychotics, with the following search terms: sleep; sedation; somnolence; wakefulness; antipsychotics; schizophrenia, parenting, maternal behavior, and custody. The results showed that antipsychotic drugs differ in their propensity to induce sedation and do so via their effects on a variety of neurotransmitter systems. It is important to note that mothers with schizophrenia risk losing custody of their infants if they are perceived as potentially neglectful because of excessive daytime sleepiness. Clinicians must choose antipsychotic medications carefully and monitor for sedative effects whenever the patient has important responsibilities that require the maintenance of vigilance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Roehrs T, Greenwald M, Roth T: Risk-taking behavior: Effects of ethanol, caffeine, and basal sleepiness. Sleep 27:887–893, 2004

    PubMed  Google Scholar 

  2. Roth T, Roehrs TA: Etiologies and sequelae of excessive daytime sleepiness. Clinical Therapeutics 18:562–576, 1996

    Article  PubMed  CAS  Google Scholar 

  3. de Moura Campos E, Mourão Melo C, Soares MW, et al.: Sleep disturbances and gender differences in schizophrenia. Sleep Science 21:27–30, 2008

    Google Scholar 

  4. Johns MW: A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep 14:540–545, 1991.

    PubMed  CAS  Google Scholar 

  5. Lindberg N, Virkkunen M, Tani P, et al.: Effect of a single-dose of olanzapine on sleep in healthy females and males. International Clinical Psychopharmacology 17:177–184, 2002.

    Article  PubMed  CAS  Google Scholar 

  6. Roth T, Roehrs TA, Moskowitz H: Issues in drug-related performance impairment. Clinical Therapeutics 14:654–666, 1992.

    PubMed  CAS  Google Scholar 

  7. Brunnauer A, Laux G, Zwick S: Driving simulator performance and psychomotor functions of schizophrenic patients treated with antipsychotics. European Archives of Psychiatry and Clinical Neuroscience 259:483–489, 2009.

    Article  PubMed  Google Scholar 

  8. De Las Cuevas C, Ramallo Y, Sanz EJ: Psychomotor performance and fitness to drive: The influence of psychiatric disease and its pharmacological treatment. Psychiatric Research 176:236–241, 2010.

  9. Rapoport MJ, Baniña MC: Impact of psychotropic medications on simulated driving: A critical review. CNS Drugs 21:503–519, 2007.

    Article  PubMed  CAS  Google Scholar 

  10. Ravera S, Hummel SA, Stolk P, et al.: The use of driving impairing medicines: A European survey. European Journal of Clinical Pharmacology 65:1139–1147, 2009.

    Article  PubMed  Google Scholar 

  11. Botch SR, Johnson RD: Antiemetic and sedative levels found together in 26 civil aviation pilot fatalities, 2000–2006. Aviation, Space, and Environmental Medicine 79:607–610, 2008.

    Article  PubMed  Google Scholar 

  12. Canfield DV, Salazar GJ, Lewis RJ, et al.: Pilot medical history and medications found in post mortem specimens from aviation accidents. Aviation, Space, and Environmental Medicine 77:1171–1173, 2006

    PubMed  Google Scholar 

  13. Chaturvedi AK, Craft KJ, Canfield DV, et al.: Toxicological findings from 1587 civil aviation accident pilot fatalities, 1999–2003. Aviation, Space, and Environmental Medicine 76:1145–1150, 2005

    PubMed  CAS  Google Scholar 

  14. Cashman CM, Ruotsalainen JH, Greiner BA, et al.: Alcohol and drug screening of occupational drivers for preventing injury. Cochrane Database of Systematic Reviews 2:CD006566, 2009.

    Google Scholar 

  15. Kraus JF: The effects of certain drug-testing programs on injury reduction in the workplace: An evidence-based review. International Journal of Occupational Environmental Health 7:103–108, 2001.

    CAS  Google Scholar 

  16. Lehtola MM, van der Molen HF, Lappalainen J, et al.: The effectiveness of interventions for preventing injuries in the construction industry: A systematic review. American Journal of Preventive Medicine 35:77–85, 2008.

    Article  PubMed  Google Scholar 

  17. Howard LM: Fertility and pregnancy in women with psychotic disorders. European Journal of Obstetrics, Gynecology and Reproductive Biology 119:3–10, 2005.

    Article  Google Scholar 

  18. Laursen TM, Munk-Olsen T: Reproductive patterns in psychotic patients. Schizophrenia Research 121:234–240, 2010.

    Article  PubMed  CAS  Google Scholar 

  19. Kurth E, Spichiger E, Zemp Stutz E, et al.: Crying babies, tired mothers—challenges of the postnatal hospital stay: An interpretive phenomenological study. BMC Pregnancy Childbirth 10:21, 2010.

    Article  PubMed  Google Scholar 

  20. Anonymous: http://www.askapatient.com/viewrating.asp?drug=20639&name=SEROQUEL 2/22/2010. Retrieved Oct 6, 2010.

  21. Miller LJ: Sexuality, reproduction, and family planning in women with schizophrenia. Schizophrenia Bulletin 23:623–635, 1997.

    PubMed  CAS  Google Scholar 

  22. Nilsson E, Lichtenstein P, Cnattingius S, et al.: Women with schizophrenia: Pregnancy outcome and infant death among their offspring. Schizophrenia Research 58:221–229, 2002.

    Article  PubMed  Google Scholar 

  23. Nicholson J: Use of child custody as leverage to improve treatment adherence. Psychiatric Services 56:357–358, 2005.

    Article  PubMed  Google Scholar 

  24. Benson KL: Sleep in schizophrenia: Impairments, correlates, and treatment. Psychiatric Clinics of North America 29:1033–1045, 2006.

    Article  PubMed  Google Scholar 

  25. Cohrs S: Sleep disturbances in patients with schizophrenia: Impact and effect of antipsychotics. CNS Drugs 22:939–962, 2008.

    Article  PubMed  CAS  Google Scholar 

  26. Kane JM: Sedation as a side effect of the treatment of mental disorders. Journal of Clinical Psychiatry 69:e20, 2008.

    Article  PubMed  Google Scholar 

  27. Kane JM, Sharif ZA: Atypical antipsychotics: Sedation versus efficacy. Journal of Clinical Psychiatry 69(Suppl 1):18–31, 2008.

    Google Scholar 

  28. Krystal AD, Goforth HW, Roth T: Effects of antipsychotic medications on sleep in schizophrenia. International Clinical Psychopharmacology 23:150–160, 2008.

    Article  PubMed  Google Scholar 

  29. Schubert EW, Blennow G, McNeil TF: Wakefulness and arousal in neonates born to women with schizophrenia: Diminished arousal and its association with neurological deviations. Schizophrenia Research 22:49–59, 1996.

    Article  PubMed  CAS  Google Scholar 

  30. Silva MR, Bernardi MM, Felicio LF: Effects of dopamine receptor antagonists on ongoing maternal behavior in rats. Pharmacology, Biochemistry and Behavior 68:461–468, 2001.

    Article  CAS  Google Scholar 

  31. Li M, Davidson P, Budin R, et al.: Effects of typical and atypical antipsychotic drugs on maternal behavior in postpartum female rats. Schizophrenia Research 70:69–80, 2004.

    Article  PubMed  Google Scholar 

  32. Zhao C, Li M: Sedation and disruption of maternal motivation underlie the disruptive effects of antipsychotic treatment on rat maternal behavior. Pharmacology, Biochemistry and Behavior 92:147–156, 2009.

    Article  CAS  Google Scholar 

  33. Fleming AS, Corter C: Factors influencing maternal responsiveness in humans: Usefulness of an animal model. Psychoneuroendocrinology 13:189–212, 1988.

    Article  PubMed  CAS  Google Scholar 

  34. Kristal MB: The biopsychology of maternal behavior in nonhuman mammals. ILAR Journal 50:51–63, 2009.

    PubMed  CAS  Google Scholar 

  35. Larsson K: The psychobiology of parenting in mammals. Scandinavian Journal of Psychology 35:97–143, 1994.

    Article  PubMed  CAS  Google Scholar 

  36. Poindron P: Mechanisms of activation of maternal behaviour in mammals. Reproduction, Nutrition, Development 45:341–351, 2005

    Article  PubMed  Google Scholar 

  37. Murillo-Rodríguez E, Arias-Carrión O, Sanguino-Rodríguez K, et al.: Mechanisms of sleep-wake cycle modulation. CNS & Neurological Disorders Drug Targets 8:245–253, 2009.

    Article  Google Scholar 

  38. Dzirasa K, Ribeiro S, Costa R, et al.: Dopaminergic control of sleep-wake states. Journal of Neuroscience 26:10577–10589, 2006.

    Article  PubMed  CAS  Google Scholar 

  39. Monti JM, Monti D: The involvement of dopamine in the modulation of sleep and waking. Sleep Medicine Reviews 11:113–133, 2007.

    Article  PubMed  Google Scholar 

  40. Monti JM, Jantos H: The roles of dopamine and serotonin, and of their receptors, in regulating sleep and waking. Progress in Brain Research 172:625–646, 2008.

    Article  PubMed  CAS  Google Scholar 

  41. Qu W-M, Xu X-H, Yan M-M, et al.: Essential role of dopamine D2 receptor in the maintenance of wakefulness, but not in homeostatic regulation of sleep, in Mice. The Journal of Neuroscience 30:4382–4389, 2010.

    Article  PubMed  CAS  Google Scholar 

  42. Giménez S, Clos S, Romero S, et al.: Effects of olanzapine, risperidone and haloperidol on sleep after a single oral morning dose in healthy volunteers. Psychopharmacology (Berlin) 190:507–516, 2007

    Article  Google Scholar 

  43. Leucht S, Corves C, Arbter D, et al.: Second-generation versus first-generation antipsychotic drugs for schizophrenia: A meta-analysis. Lancet 373:31–41, 2009.

    Article  PubMed  CAS  Google Scholar 

  44. Ishida T, Obara Y, Kamei C: Effects of some antipsychotics and a benzodiazepine hypnotic on the sleep-wake pattern in an animal model of schizophrenia. Journal of Pharmacological Science 111:44–52, 2009.

    Article  CAS  Google Scholar 

  45. Bell JS, Taipale HT, Soini H, et al.: Sedative load among long-term care facility residents with and without dementia: A cross-sectional study. Clinical Drug Investigation 30:63–70, 2010.

    Article  PubMed  Google Scholar 

  46. Said Q, Gutterman EM, Kim MS, et al.: Somnolence effects of antipsychotic medications and the risk of unintentional injury. Pharmacoepidemiology and Drug Safety 17:354–364, 2008.

    Article  PubMed  CAS  Google Scholar 

  47. Chen YY, Wu KC: Sleep habits and excessive daytime sleepiness correlate with injury risks in the general population in Taiwan. Injury Prevention 16:172–177, 2010.

    Article  PubMed  Google Scholar 

  48. Ackerson BJ: Coping with the dual demands of severe mental illness and parenting: The parents’ perspective. Families in Society 84:109–118, 2003.

    Google Scholar 

  49. Hollingsworth L: Child custody loss among women with persistent severe mental illness. Social Work Research 28:199–209, 2004.

    Article  Google Scholar 

  50. Gewurtz R, Krupa T, Eastabrook S, et al.: Prevalence and characteristics of parenting among people served by Assertive Community Treatment. Psychiatric Rehabilitation Journal 28:63–65, 2004.

    Article  PubMed  Google Scholar 

  51. Nicholson J, Sweeny E, Geller J (1998) Mothers with mental illness: II. Family relationships and the context of parenting. Psychiatric Services 49:643–649.

    PubMed  CAS  Google Scholar 

  52. Black J, Duntley SP, Bogan RK (2007) Recent advances in the treatment and management of excessive daytime sleepiness. CNS Spectrum 12(2 Suppl 2):1–14.

    Google Scholar 

  53. Leibowitz SM, Brooks SN, Black JE, et al.: Excessive daytime sleepiness: Considerations for the psychiatrist. Psychiatric Clinics of North America 29:921–945, 2006.

    Article  PubMed  Google Scholar 

  54. Pagel JF: Excessive daytime sleepiness. American Family Physician 79:391–396, 2009.

    PubMed  CAS  Google Scholar 

  55. Wezenberg E, Sabbe BGC, Verkes RJ: The role of sedation tests in identifying sedative drug effects in healthy volunteers and their power to dissociate sedative-related impairments from memory dysfunctions. Journal of Psychopharmacology 21:579–587, 2007.

    Article  PubMed  CAS  Google Scholar 

  56. Wise MS: Objective measures of sleepiness and wakefulness: Application to the real world? Journal of Clinical Neurophysiology 23:39–49, 2006.

    Article  PubMed  Google Scholar 

  57. Wichniak A, Waliniowska E, Wierzbicka A: Sleep quality and daytime sleepiness in schizophrenia spectrum disorders during antipsychotic treatment. Psychiatria Polska 43:193–202, 2009.

    PubMed  Google Scholar 

  58. Morein-Zamir S, Turner DC, Sahakian BJA: Review of the effects of modafinil on cognition in schizophrenia. Schizophrenia Bulletin 33:1298–1306, 2007.

    Article  PubMed  Google Scholar 

  59. Saavedra-Velez C, Yusim A, Anbarasan D, et al.: Modafinil as an adjunctive treatment of sedation, negative symptoms, and cognition in schizophrenia: A critical review. Journal of Clinical Psychiatry 70:104–112, 2009.

    Article  PubMed  CAS  Google Scholar 

  60. Freudenreich O, Henderson DC, Macklin EA, et al.: Modafinil for clozapine-treated schizophrenia patients: A double-blind, placebo-controlled pilot trial. Journal of Clinical Psychiatry 70:1674–1680, 2009.

    Article  PubMed  CAS  Google Scholar 

  61. Rychnovsky J, Hunter LP: The relationship between sleep characteristics and fatigue in healthy postpartum active duty women. Women’s Health Issues 19:38–44, 2009

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mary V. Seeman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Seeman, M.V. Antipsychotic-Induced Somnolence in Mothers with Schizophrenia. Psychiatr Q 83, 83–89 (2012). https://doi.org/10.1007/s11126-011-9185-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11126-011-9185-z

Keywords

Navigation