If you have taken antidepressant medication like Zoloft, Prozac or Lexapro to name a few, you may have experienced bizarre or intense dreams. This very disturbing, it does not mean the medication is making you worse.
Antidepressants suppress the REM stage of sleep which is the stage where you dream. The effect of this suppression is that you can get REM rebound where you experience very intense dreams. Changing medication may help as the effect may not manifest as much with the different medication.
Use the grounding tools in these cards to help with sleep.
Updated 2024
The Role of Serotonin in Sleep
Serotonin, a key neurotransmitter in our brain, plays a crucial role in regulating our mood, appetite, and sleep cycles. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), increase serotonin levels in the brain. While this is beneficial for improving mood, it also has a significant impact on our sleep patterns, particularly the Rapid Eye Movement (REM) phase, which is associated with vivid dreaming.
REM Suppression and Rebound
During normal sleep, REM cycles are evenly distributed. However, increased serotonin levels lead to REM suppression. As the body adapts to the medication, there’s often a ‘REM rebound’ – a phase where the intensity and frequency of REM sleep increase, resulting in more vivid, intense, and often memorable dreams.
Common Antidepressants and Dream Intensity
- SSRIs (e.g., Prozac, Zoloft) and SNRIs (e.g., Effexor) are known for causing vivid dreams.
- Tricyclic antidepressants can also affect dream patterns due to their impact on multiple neurotransmitters.
Frequently asked Questions About Antidepressants and Dreams
Q: Is it normal to have vivid dreams on antidepressants?
A: Yes, it’s a common side effect due to changes in REM sleep.
Q: Do these vivid dreams have any psychological implications?
A: In most cases, they are a benign side effect. However, if dreams are disturbing or affecting sleep quality, it’s important to discuss this with your healthcare provider.
Q: Can starting or changing the dose of an antidepressant affect dream patterns?
A: Yes, starting or adjusting the dosage of an antidepressant can alter dream patterns. These changes are often due to the medication’s impact on neurotransmitters like serotonin, which influence sleep cycles and dreaming.
Q: Are vivid dreams caused by antidepressants a sign of a serious problem?
A: Vivid dreams caused by antidepressants are usually not a sign of a serious problem. They are a common side effect of how these medications affect brain chemistry. However, if the dreams are distressing or significantly disrupt sleep, it’s important to consult with your healthcare provider.
Q: Will the vivid dreams go away over time while on the medication?
In many cases, vivid dreams may decrease over time as the body adjusts to the medication. However, the duration and intensity can vary among individuals..
Q: Do all types of antidepressants cause vivid dreams?
A: Not all antidepressants have the same effect on dreams. SSRIs and SNRIs are more commonly associated with changes in dream patterns, while other types might have different effects on sleep and dreaming.
Q: Can changing the timing of taking antidepressants reduce vivid dreams?
A: It may be beneficial for some individuals to take antidepressants in the morning to reduce the impact on their sleep and dreams. However, it’s important to always consult with a healthcare provider before making any changes.
Q: Are there any strategies to cope with vivid dreams caused by antidepressants?
A: Good sleep hygiene, stress reduction techniques, and sometimes adjusting the medication (under a doctor’s supervision) can help manage vivid dreams. Keeping a dream journal may also provide insight into any recurring patterns or triggers.
Conclusion
Vivid dreams caused by antidepressants are a result of the medication’s impact on our sleep cycle and serotonin levels. While typically not a cause for concern, it’s important to monitor these changes and discuss them with a healthcare professional if they become distressing.
Recent Research Insights
Recent studies have indicated that while the effect on dreams is usually temporary, it can be unsettling for some people. Here are a few recent studies.
Hutka P, Krivosova M, Muchova Z, et al. Association of Sleep Architecture and Physiology with Depressive Disorder and Antidepressants Treatment. Int J Mol Sci. 2021;22(3):1333. Published 2021 Jan 29. doi:10.3390/ijms22031333
Nicolas A, Ruby PM. Dreams, Sleep, and Psychotropic Drugs. Front Neurol. 2020;11:507495. Published 2020 Nov 5. doi:10.3389/fneur.2020.507495
Wichniak A, Wierzbicka A, Wal?cka M, Jernajczyk W. Effects of Antidepressants on Sleep. Curr Psychiatry Rep. 2017;19(9):63. Published 2017 Aug 9. doi:10.1007/s11920-017-0816-4
I took Wellbutrin 3 years ago (start of 2020) for a month and it completely destroyed my brain. Since the very first day I had insanely bad issues with vivid dreams, insomnia and exhaustion.
After a few weeks of taking it, it became 1000x worse. I felt like I was on crack. My mind was racing so fast, and my thoughts were screaming. I slept 2-3 hours a night for the next 3 months. It did improve after that. But I still have extremely vivid dreams, I talk/scream in my sleep, kick my feet, and wake up exhausted every single day. Which is HORRIBLE for someone prone to depression; finding motivation when you are this tired? So tired you feel sick? Yeah..
I stopped taking ALL pills after that and since then. I would do anything to go back to before when I had restful sleeps. ANYTHING.
I was given antidepressants as a child into adulthood for around 10 years. I stopped taking it for another decade before the Wellbutrin. Perhaps that had some effect on me, the strange thing is, this was the first time an Antidepressant actually did make me feel happy, even as a kid. I was given them so I just took them. I had taken a dozen different kinds and they literally did nothing. The Wellbutrin made me happy but at the cost of permanently affecting my sleep.
I caution people from using them IF they think they can use alternative methods effectively (therapy, exercise, etc.). There IS a risk with these things and so they should be taken seriously and IMO used as a last resort, rather than first.
Please help! I’m taking 20 mg of Lexapro and I have really vivid dreams. these dreams consist of a lot of things that usually give me anxiety (people being mad at me, someone ignoring me) I wake up DRENCHED in sweat almost every night and my room is freezing. Can someone help?
Hi
Did the dreams start when you started taking lexapro?
I recommend not to eat gluten, so bread etc. at dinner or later.
This helped me enormously.
You can get anxious from gluten and sugar, its something you need during the day for energy but not at night.
Also try taking your medicine in the morning or at night, see the difference.
Relax your brain. Go out fight or flight mode, look it up.
Pray, seek help in a church.
Talk about it with your psychiatry.
Much love, you will be fine, i have been through it, keep seeking and trying, dont give up, but also chill. Eventually you will find an answer.
Also use natural materials in bed sheets from cotton, also the filling of your bed sheets, also what you wear. Its better for the temperature. If youre to warm you will get nightmares, also open ventilation or window for a small piece. Find the right temperature for you. This changes with the seasons.
When I read your comment, I felt like I could cry. For years I suffered with what you are saying, kicking, screaming, talking, drenching and sweat. I had a very active dream life since I was a child so I just attributed it to that, or menopause, or being bipolar, or sleep disorder or apnea. When things started getting a little better in my life years and years and years and years after, I was just grateful, but I didn’t specifically Thinking to correlate it with anything. I don’t see how anyone should be made to suffer through this, the only thing I can think of that would be worth it is if you were suicidal and the medication is the absolute only one that has helped save your life. I might suggest otherwise you keep trying, if your psychiatrist is not on top of it getting new psychiatrist. Seriously sleep is one of the most important things to Mental Health and all around Health. I don’t see how they can be treating us for depression and yet leave us without sleeping. Makes no sense. if it’s a temporary side effect OK it’s worth waiting a bit but otherwise don’t suffer like this for years. Wishing you strength and balance keep going and hold positive vision in your mind
I have titrated off lexapro and my dreams are crazy. Vivid, nearly lucid and colorful and sometimes frantic. What’s up? I used to have lucid dreams before I began taking it. Was in it for 17 years. Now retired and off of it ands feeling really good. O
I’ve been on Lexapro and thankful to have a doctor that started me on the lowest dose so that I could use the smallest possible that helps me. I have bizarre dreams, and sometimes when I think back, they are a mishmash of things that I read, saw, or thought of, sometimes it is of completely random things like a black cat sprouting bat wings and smoking a cigarette ?
I take Escitalipram 10, buspirone 10 in the morning and trazodone 50 at night. My dreams have been so vivid that I am having a hard time deciphering dream from reality. Is it the combination or a singular drug that could be causing this? The dreams aren’t bad dreams, they’re just very strange and realistic.
I take escitalopram 10mg and have the exact same problem. I won’t realise it was actually a dream until something happens in real life that proves it had to be a dream. Or I’ll have a conversation with someone about something that happened in my dream thinking it was real. Bit weird but I’m living with it.
I am on Zoloft 75 mg, and I just woke up from a buzzard dream and woke up and didn’t know where I was because I really thought the dream was real, and had a panic attack. I am still feeling like I am not awake. I have been having vivid dreams, but nothing close to this. I’m scared.
You should talk to your doctor about switching if it keeps happening. Most of the patients I see continue to have the dreams from time to time, but they get use to it.
Hey, I took fluoxetine for 4 months , then later I had gastrointestinal problems, low energy, and semen leakage and nightmares, I took different medications yet they dont go away, I took paroxetine, duloxetine,.Escilatorpram oxalae worsened it. Amitriptylike did help up to some extent but stops working every two weeks , Now I am on imipramine donot know will it help. It has been since 2 years yet I am dreaming a lot, The very next morning due to vivid dreams I feel extremely tired.
Buproprion may not do it. But it may be that you have to use a non-medication treatment or an off-label (non-FDA approved) medication to treat your condition.
I just started taking Buproprion and I’ve started having crazy, vivid dreams. Before starting the medication, I hadn’t dreamed like that in years…
The dreams do not go over after a few weeks?
For some people they may, but for many people they come and go indefinitely while they are taking the medication
I have this problem for 10 years chronic fatigue syndrom because of the dreams mostly.
I’ve reduction from 20 mg to 10 mg of proxitine then come off them being on them for about 14 month s I get weird dreams how long will this last
I have been on the generic form of lexapro for 2 months now. The good thing is that it has helped my insomnia tremendously as well as my depression and anxiety for the most part. I do have vivid dreams pretty much every night now – all night long, but they are not necessarily bad. Sometimes they are a little stressful but other times they are just wild. I have always loved vivid dreaming and I find them super interesting, so it is not so bad for me.
Hm good point. I think, if the dreams are not frightening you, and if you are improved all around in your life, and if you feel rested… It seems you would be one of the people who these side effects are tolerable for
while I was on Bupropion (Wellbutrin I had such vivid dreams, they were very distrurbing and I could recall them the next day all day. I always woke in a sweat and panic. They were suppliementing Celexa. My new doctor took me off both and I started on sertraline((/Zoloft?). At first they did not affect me but now I have vivid dreams. Not necessarily disturbing but still very vivid. They fade during the day but stay with me in the morning. Not sure I really want to change again. It was a little traumatic the last time.
I take Zoloft I’ve been taking it for a little over a month and I’ve noticed I’ve had some vivid dreams but it’s not disturbing me. I’m a bit confused about the suppressing of REM sleep what does that do to a person is that bad?
Hey Dr Tracey, I am currently on amitriptyline , I have to keep increasing dose because it stops working about 15 dyas, Currently on on 75, but this also feels like it has stoped working now again I have to increase dosage, This means one day it will exceed 200 mg or 1000mg , should I switch to other or after some limit I no longer need to increase dosage?
I even have subsribed your youtube channel.
Many doctors in my country has no idea regarding anti – deprresant. Will you help me ?
Hey Dr Tracey. I took prozac for 6 months and went cold turkey later on I experience semen leakage , accumulation of gas in stomach . I got frightened and took myself 20 mg for about a month and went cold turkey. then there after i experience nightmare , low energy or sleepy all time , semen leakage and accumulation of gas in stomach.
then its been 3 years yet I have those symptoms. Doctor prescribed many other anti depressants yet so far nothing worked. Amitriptyline did help half, but I couldn’t continue after 24 days. But then i took Lexapro , it exaggerated the situation to worse. Now I am crying all time . Any help ?
The number one piece of information with all psychiatric drugs isYOU CANNOT GO OLD TURKEY. if you are in such an emergency that you absolutely feel you cannot go on without a change of medicine. You must go to an emergency room and hospitalize. I’m not a doctor, but I am saying from decades of treatment. I know this to be true. I know it from the literature. I know it from the healthcare professionals. I know it from the psychiatrist. I know it from my experience.PLEASE
Sometimes I would forget to take my medication (setraline) for 3 days max, and then have nightmares. I would take them again and be okay. But now I’m noticing that I’ve been my medication regularly, but getting the nightmares again all of a sudden. I have the lowest dose of Setraline and it’s the 3rd type of antidepressant that I’ve tried and finally found to work well with me. I don’t want to have to switch again.
I’ve been on almost all of the SSRIs, clomipramine, and various augmenting medications for my OCD, depression, anxiety and ptsd. I’ve also had ketamine infusions and done deep transcranial magnetic stimulation. Some of these have helped my ocd, such as Prozac and Lexapro, but the vivid, nightmare dreams was too much for me. I’ve been on Zoloft for many years. My dreams aren’t bad on it, but I do battle other side effects like jitteriness.
I wish these medications did more to help those of us with treatment resistant conditions. I do believe they are making progress in developing new treatments that target glutamate, etc.
Anyway, thanks for your videos and wisdom Dr Marks! Best! Don
Thanks for sharing Don. Boy you have had a lot of treatments. Progress on new options is slow, but progress none the less. Hang in there. In the meantime it is worthwhile prioritizing eating a diet that doesn’t promote inflammation. Here’s a video I did on the Depression Diet in case you didn’t see it. https://youtu.be/Y1HI1aZ58RY
I really enjoyed Don’s comment. I came here today in search of some answers hopefully! My girlfriend has had anxiety and depression her whole life. Her parents didn’t believe in meds. Finally after a family tragedy they finally agreed to put her on medication at 24. She’s been on lexapro for 4 years. She’s 28. Since highschool she also cut. She hasn’t cut in years but she picks at herself and it causes little scabs everywhere particularly on her face. This is only done when she’s having major anxiety or a panic attack. However I think it’s mostly done during sleep when she scratches and moves around a lot. She’s explained how she’s always had vivid dreams but now they’re insane and she has cold sweats 2-3 a week. She was on these “nightmare meds” for awhile but they didn’t really work. Her doctor put her on another med to take instead of the Lexapro but we believe she’s allergic as she threw up and had some blood in stool. However she said she has never felt better on a medication happiness wise. She’s going in to get a prick to see if she was allergic but just trying to see if you have any suggestions! Thank you for your time.
How long does it take once you are off the medicine for the dreams to stop? Thank You!
It varies from person to person. I’ve had some people say it only took a few days and others say a month or more. Most of the antidepressants take a couple of weeks to get out of your system, whereas the longer acting ones like Prozac can take a month.
Is there anything wrong with the vivid dreams? Despite them not being pleasant, I find it nice to be remembering so much of my dreams. Is it harming me somehow?
The dreams themselves are not dangerous, what matters is how you experience them. Some people are bothered and others not.
I love the intense dreams. It’s like a new adventure every night!
I feel the same way! My husband is in chemo treatment and because of that I’ve been on Zoloft 25mg for 3 months now and I’m enjoying my dreams … they are like colorful movies and have (so far) been very pleasant. I have always remembered my dreams but now on this medication they are very vivid!
I started treatment for depression about 25 years ago, on certraline. This dosage maxed out and eventually became less effective. I was then put on venlafaxine which also maxed out some years back. I also have been taking bupropion for anxiety for a few years too, also maxed out. Since retiring 11 years ago, I have been having recurring vivid and violent dreams. I actually act out in my sleep, kicking and punching. I have injured my toes a few times kicking walls. Could these meds be causing the bad dreams? I often dread sleeping.
I’m on medication for OCD and I’ve experienced intense dreams. I don’t mind them, they are almost like watching a scary movie. I know they’re not real, and sometimes they’re entertaining. I find this so fascinating, thank you so much for explaining it.
I recently just started on Fluvoxamine Maleate 50mg pills and have had extremely intense nightmares that even happened on my first night of taking it. I also have a bad toe and had woke up in a panicked state multiple times that night, but thought that was also a dream because my other medication leaves me incredibly disoriented if I’m woke up shortly after falling asleep. The next day I had found that my sock was drenched in blood and I realized that I had actually fallen out of bed and tried to call people while half asleep and in a panicked state. I’m definitely going to check with my doctor about changing my antidepressant after learning that it can cause night terrors like this. Thanks a bunch for having this website up, it helped me catch this really early on.
I have been on sertraline for over a year now I take 100mg daily for PTSD. The nightmares only started recently. Although it isn’t the nightmares that bother me, but in my dreams I get nervous about what I’m dreaming about that I wake up in a puddle of sweat. The sweat has caused me to break out which is my main concern. I also have 10mg of hydroxizine that was recommended to take before bed but I did not notice a difference. Any suggestions? I don’t want to switch my antidepressant because it worked in many positive ways.
You could talk with your doctor about lowering the medication to see if that helps. If it doesn’t, there’s not much of a work around when the medicine causes nightmares.
Hi. I too have been experiencing intense and emotional dreams that are affecting my mood and demeanor since taking Fluoxetine during the day and Trazadone before bed. I believe both are generic brands.
Will they ever stop? I’m a bit scared to even go to sleep at this point. My mom thinks that watching a nice calming movie before bed will help, but will it? Is it ok to stop taking anti depressants? Will it affect my health?
Hi Samarah. In my experience with patients, the dreams last for as long as they are on the medication. If they are that distressing for you, you should talk with your doctor about switching to a different one. Any of them can do it, but not all do and it’s trial and error to find one that doesn’t have the effect. You don’t want to just stop taking the medication without a taper off.
I am not a doctor, but I think being afraid to go to sleep is definitely a harm to your health. It is true you should try natural things like absolutely not being on your device before you go to sleep. Definitely not any disturbing movies nor disturbing TV! no caffeine and no sugar!! Some people feel not too hot and not too cold shower or bath is helpful. Also for me, it makes a big difference if I make a “gratitude list“ in the morning and the night of all the things I am thankful for… When a person is depressed, it can be very hard focus on the positive but when you get in the habit of making these lists, it helps re-organize your mind by thinking of the positive things that you actually do have . I recommend you find very calming Music or what I found helpful myself positive affirmation recordings, or subliminal sleep recordings I really like Jason Stephenson on YouTube… I am not an advertiser. This is just a simple reference/idea. Of course, that usually means I have to have my device near me, but I make sure that the light is off on the device and that it is not near my head. Do not keep it in the bed with you!! ( that is another health risk)
I am on 10mg of escitalapram for general anxiety disorder and get very intense dreams, which leave me exhausted the next day. I have tried other SSRIs which all do the same thing. Is there any type of anti depressant/anti anxiety medication on the market that would not cause vivid dreams?
Hi Tasha. The standard medications to treat anxiety are the serotonin-enhancing antidepressants. Any of them could affect your dreaming, but you could get on one that does not. Buspar, Propranolol and Neurontin are other medications to treat anxiety, but they may not work as well for you and they come with other side effects. Probably your best bet is to talk with your doctor about trying a different antidepressant. Good luck.
Hi Tasha, I am one of those clients for whom propranolol and gabapentin did help quite a bit. So it’s a possibility. I don’t think it’s going to be a sure bet for anyone but it’s a possibility.
When I was on the brand name Lexapro I had no problems. My bad dreams began when I received the generic form. It was during the second month taking the generic that I noticed it. Doctor prescriber BRAND NAME ONLY after that. I never had a problem.
Hi Jody. Thanks for the comment. I see this a lot with different generics resulting in different side effects. I’m glad going with the brand resolved the problem for you.