Effects of bupropion and SSRI antidepressants on leg movement activity and chin muscle tone during sleep in adolescents

Study Objectives: To evaluate the effects of bupropion on periodic limb movements during sleep (PLMS) and chin electromyography tone in children taking it for their mood disorder, compared to the effects of selective serotonin reuptake inhibitors (SSRIs) and of bupropion combined with SSRIs.Methods: Six adolescents (aged 16.0 & PLUSMN; 0.63 years) taking bupropion alone and 6 adolescents (aged 15.9 & PLUSMN; 1.36 years) taking bupropion in combination with an SSRI antidepressant were recruited, along with 10 adolescents (aged 16.2 & PLUSMN; 0.2 years) taking different SSRIs, and they were also enrolled together with 17 age-and sex-matched control patients (aged 15.5 & PLUSMN; 1.26 years). Polysomnographic studies were obtained, and participants' leg movement activity during sleep and muscle tone were assessed quantitatively (atonia index) during all sleep stages.Results: Participants taking SSRIs showed PLMS indices significantly higher than those of control patients, whereas adolescents taking bupropion showed only slightly increased indexes of nonperiodic leg movements during sleep. No differences in PLMS were observed between adolescents taking bupropion alone or in association with SSRIs. The atonia index showed, within each sleep stage, the lowest values in the 2 groups taking SSRIs and the highest in the control patients; adolescents taking bupropion alone tended to show values slightly smaller than those of the control patients.Conclusions: We found that similar to adults, in adolescents SSRIs but not bupropion are associated with increased PLMS. Bupropion also seems to counteract the SSRI-induced increase of PLMS, when administered in combination; thus, the dopaminergic effect of bupropion seems to outmatch the antidopaminergic action of SSRIs. Conversely, bupropion does not counteract the effects of SSRIs on chin electromyography tone.Keywords: bupropion, SSRI antidepressants, periodic leg movements during sleep, leg movement activity during sleep, periodicity index, atonia index, chin EMG tone, adolescentsCitation: DelRosso LM, Mogavero MP, Fickensher A, Bruni O, Schenck CH, Ferri R. Effects of bupropion and SSRI antidepressants on leg movement activity and chin muscle tone during sleep in adolescents. J Clin Sleep Med. 2023;19(1):151-161.

Automated summary

This study aims to evaluate the effects of bupropion on periodic limb movements during sleep (PLMS) and chin electromyography tone in children with mood disorders, compared to SSRIs and the combination of bupropion and SSRIs. The results show that SSRIs significantly increase PLMS, while bupropion only slightly increases nonperiodic leg movements during sleep. Bupropion appears to counteract the SSRI-induced increase in PLMS when administered in combination, but has no effect on the effects of SSRIs on chin electromyography tone.