Bupropion SR reduces periodic limb movements associated with arousals from sleep in depressed patients with periodic limb movement disorder

Background: Antidepressant-induced periodic limb movement disorder (PLMD) may limit the tolerability of some antidepressant medications and interfere with treatment response. Given the role of dopamine in PLMD and the effects of bupropion sustained-release (SR) on central dopaminergic function, we hypothesized that bupropion SR would not be associated with antidepressant-induced PLMD. Method: In an expanded case-series design, we compared the effects of bupropion SR, after about 10 weeks of treatment, on measures of PLMD, depression, and sleep in 5 depressed (Research Diagnostic Criteria) patients who also met criteria for having pretreatment PLMD. Depression was measured using the Beck Depression Inventory and the Hamilton Rating Scale for Depression. Patients were considered to have PLMD if polysomnographic recordings showed > 5 periodic limb movements/hour of sleep that were associated with arousals from sleep. Results: Bupropion SR treatment was associated with a reduction in measures of PLMD and an improvement in depression. Conclusion: These results show that bupropion SR is not associated with antidepressant-induced PLMD, Rather, bupropion SR treatment reduces objective measures of PLMD in depressed patients with the disorder.