While more research is needed to understand exactly why this happens, being aware of this potential effect can help you feel more prepared if you find yourself baffled by your dreams or nightmares.
How Antidepressants Affect Dreams
If you have clinical depression, you’re probably familiar with the wee hours of the morning. Depression is known to cause sleep disturbances such as insomnia, early morning awakenings, and bad dreams or nightmares. In fact, it has been shown to alter the part of sleep associated with rapid eye movements called REM sleep, where dreaming occurs. Specifically, depression decreases the length of time it takes to enter REM sleep (called REM sleep latency) and increases the frequency of rapid eye movements during sleep (called REM sleep density). In conjunction with these changes in REM sleep, people with depression report having more negative, or bad, dreams. Research has shown that antidepressants may induce different dream emotions, which can lead to both pleasant dreams or nightmares. Antidepressants can also influence how often you dream and decrease your recall of dreams. This lines up with what patients tend to report about their sleep while on antidepressants.
Studying the Impact of Antidepressants
In a 2013 report that was published in Sleep Medicine Reviews, Gotthard Tribl and his research team completed a systematic review that examined the impact of antidepressants on dream content in both depressed and non-depressed individuals. The studies compared dream content across a spectrum of different antidepressants as well as making comparisons between the dream content of those taking or not taking an antidepressant. A variety of methods were used to record dream content, including:
Morning dream diaries,Immediate verbal reports upon forced awakening during REM sleepQuestionnaires designed to collect information about dream content as well as the frequency of nightmares
The Class of Antidepressant Matters
The evidence indicates that different types of antidepressants can play a role in the impact on dreams.
Tricyclic Antidepressants
Tricyclics are older antidepressants that inhibit the reuptake of serotonin and norepinephrine. They include such medications as:
Elavil (amitriptyline)Anafranil (clomipramine)Tofranil (imipramine)Surmontil (trimipramine)
Researchers have found that taking antidepressants tends to make both depressed and non-depressed individuals remember their dreams less often. This effect was most prominent for people taking tricyclic antidepressants. On the other hand, tricyclics tended to produce more positive, or pleasant, dreams.
SSRI and SNRI Antidepressants
Selective serotonin reuptake inhibitors (SSRIs) increase the amount of serotonin in the brain, and serotonin-norepinephrine reuptake inhibitors increase the amount of serotonin and norepinephrine in the brain. Examples of SSRIs include:
Celexa (citalopram)Lexapro (escitalopram)Luvox (fluvoxamine)Paxil (paroxetine)Prozac (fluoxetine)Zoloft (sertraline)
Research suggests that SSRIs are less likely to interfere with the ability to recall dreams. SNRIs include such medications as:
Cymbalta (duloxetine) Effexor (venlafaxine) Pristiq (desvenlafaxine)
Antidepressants belonging to the SSRI class, as well as serotonin-norepinephrine reuptake inhibitors (SNRIs), have been shown to intensify dreams and increase how often people reported having nightmares. One case report found that the SNRI Viibryd (vilazodone) led to intense and frightening nightmares in one patient after three doses.
Other Medications
In addition to antidepressants, other types of medication that are sometimes prescribed to treat mental health conditions are also linked to nightmares and other changes in dreams. Beta-blockers are used to treat high blood pressure and heart failure, but they are also sometimes prescribed to treat anxiety. However, research suggests that they can also impair sleep and may increase the risk of having nightmares. The monoamine oxidase inhibitor called Nardil (phenelzine) has also been shown to increase dream recall.
More Research Is Needed
Researchers have noted, however, that there has not been a lot of attention paid to dream recall and content. More studies are needed to characterize how antidepressants affect dreaming. The effect on dreams, including the increased likelihood of nightmares, may affect patient preferences regarding medication. It may also affect recommendations for which antidepressant is best suited for each individual.
A Word From Verywell
Nightmares and changes in dreaming are not frequently discussed side effects of antidepressants. However, being aware that they may occur can help you be more aware of what you can expect when you begin taking an antidepressant medication. Talk to your doctor or therapist if you are concerned about any changes in sleep or other side effects that you might be experiencing due to your antidepressant.
