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Medications associated with nightmares

Medications associated with nightmares
Medication category Examples Mechanism

Acetylcholinesterase inhibitors

Donepezil, galantamine, rivastigmine

Increase in REM intensity

Antidepressants* Bupropion, MAOIs, mirtazapine, SNRIs, SSRIs, TCAs

Increase in REM intensity with REM delay and cholinergic rebound

REM rebound (during withdrawal)

Antihistamines

Chlorpheniramine

Unclear

Antimicrobials  Ciprofloxacin, efavirenz, erythromycin, ganciclovir, mefloquine  Unclear; possibly related to cytokine modulation 
Atypical antipsychotic medications Clozapine, olanzapine, risperidone Associated with dopamine
Beta blockers Labetalol, metoprolol, propranolol Unclear; may suppress REM
Calcium channel blockers Verapamil Unclear
Dopaminergic drugs Amantadine, amphetamine, levodopa, methylphenidate, pramipexole, ropinirole, selegiline Associated with dopamine
Sedative-hypnotics*  Alcohol, barbiturates, temazepam, triazolam REM rebound
Statins Atorvastatin Unclear
REM: rapid eye movement sleep; SSRIs: selective serotonin reuptake inhibitors; SNRIs: serotonin-norepinephrine reuptake inhibitors; TCAs: tricyclic antidepressants; MAOIs: monoamine oxidase inhibitors.
* When administered and during withdrawal.
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