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Sleep-Related Eating Disorder (SRED): Paradoxical Effect of Clonazepam
Debabrata Ghosh1, Abigail M Petrecca2, Abdul Latif Khuhro1
1Neurology and Pediatrics, Nationwide Children's Hospital, Ohio State University Medical Center, Columbus, Ohio.
Insights
Clonazepam, a medication for movement disorders, can paradoxically cause sleep-related eating disorder (SRED) in children. This case highlights a rare side effect, even when clonazepam is used to treat parasomnia.
Area of Science:
- Neurology
- Sleep Medicine
- Pediatric Neurology
Background:
- Primary myoclonus dystonia and attention deficit hyperactivity disorder (ADHD) can present with complex sleep disturbances.
- Parasomnias, such as non-rapid eye movement parasomnia, can complicate the management of these conditions.
- Pharmacological interventions are often necessary but may carry risks of adverse effects.
Abstract:
A 9-year-old boy with primary myoclonus dystonia with comorbid severe attention deficit hyperactive disorder (ADHD) also had sleep onset and maintenance insomnia. Polysomnography showed features of non-rapid eye movement parasomnia. Daily bedtime clonidine helped sleep and hyperactivity. ADHD symptoms improved with 40 mg daily lisdexamphetamine mesylate. As the myoclonus and dystonia symptoms progressed, clonazepam was initiated at a dose of 0.5 mg daily at bedtime. It was anticipated that clonazepam would also improve parasomnia. Concomitant with the initiation of clonazepam, he developed a sleep-related eating disorder (SRED) continuing almost throughout the night. The symptoms went away upon stopping clonazepam. This is the first description of clonazepam producing SRED though it is the treatment of choice for this disorder.
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