Post-stroke sleep disorder treated with the selective serotonin reuptake inhibitor citalopram - A case study

Even though stroke patients not uncommonly suffer from sleep disturbance, post-stroke sleep disorder is one of the least studied sequels of stroke. We present a case study providing polysomnographic evidence for the successful alleviation of persistent insomnia in a non-depressed stroke patient by treatment with the selective serotonin reuptake inhibitor citalopram. During open treatment with citalopram the patient's sleep efficiency index improved considerably, and REM latency gradually increased. Possible causes of post-stroke insomnia are discussed, and the suggestion is made that post-stroke sleep disorder might possibly be attributable to stroke-induced disruption of pathways involved in the neurophysiology of sleep, e.g. serotonergic neurotransmission.