Subscribe to RSS
DOI: 10.1055/s-0035-1545332
Yawning in Depression: Worth Looking Into
Publication History
received
01 October 2014
revised
15 January 2015
accepted
02 February 2015
Publication Date:
27 February 2015 (online)
![](https://www.thieme-connect.de/media/pharmaco/201503/lookinside/thumbnails/10.1055-s-0035-1545332-1.jpg)
Abstract
Yawning often occurs during states of increased sleep propensity. Depression is associated with sleep problems and tiredness. The aim of this paper is to review the present knowledge about possible changes of yawning during an episode of major depression (MD) and to report data on yawning from an online depression forum comprising of 450 000 postings. A literature search did not reveal any study about yawning in people with MD when compared to controls. However, there is evidence for an increased frequency of yawning under the influence of antidepressants. Analysis of the depression forum postings revealed 63 people writing about increased yawning in the context of depression. However, all but one of them were treated with antidepressants; and yawning was not reported as a symptom of depression, but in most cases (N=56) as occurring as a result of treatment with antidepressants. These findings are in agreement with a tonic hyperarousal in typical depression which is reduced by all standard antidepressants. For clinicians, it would be of interest to know whether yawning is reduced in untreated depression and whether it predicts treatment outcome.
-
References
- 1 Guggisberg AG, Mathis J, Schnider A et al. Why do we yawn?. Neurosci Biobehav Rev 2010; 34: 1267-1276
- 2 Giganti F, Zilli I, Aboudan S et al. Sleep, sleepiness and yawning. Front Neurol Neurosci 2010; 28: 42-46
- 3 Guggisberg AG, Mathis J, Hess CW. Interplay between yawning and vigilance: a review of the experimental evidence. Front Neurol Neurosci 2010; 28: 47-54
- 4 Hegerl U, Lam RW, Malhi GS et al. Conceptualising the neurobiology of fatigue. Aust N Z J Psychiatry 2013; 47: 312-316
- 5 Armitage R. Sleep and circadian rhythms in mood disorders. Acta psychiatrica Scand 2007; 115: 104-115
- 6 Kayumov L, Rotenberg V, Buttoo K et al. Interrelationships between nocturnal sleep, daytime alertness, and sleepiness: two types of alertness proposed. J Neuropsychiatry Clin Neurosci 2000; 12: 86-90
- 7 Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiatry 2005; 66: 1254-1269
- 8 Pariante CM, Lightman SL. The HPA axis in major depression: classical theories and new developments. Trends Neurosci 2008; 31: 464-468
- 9 Wong ML, Kling MA, Munson PJ et al. Pronounced and sustained central hypernoradrenergic function in major depression with melancholic features: relation to hypercortisolism and corticotropin-releasing hormone. Proc Natl Acad Sci USA 2000; 97: 325-330
- 10 Hegerl U, Wilk K, Olbrich S et al. Hyperstable regulation of vigilance in patients with major depressive disorder. World J Biol Psychiatry 2012; 13: 436-446
- 11 Olbrich S, Sander C, Minkwitz J et al. EEG vigilance regulation patterns and their discriminative power to separate patients with major depression from healthy controls. Neuropsychobiology 2012; 65: 188-194
- 12 Ulrich G, Fuerstenberg U. Quantitative assessment of dynamic electroencephalogram (EEG) organization as a tool for subtyping depressive syndromes. Eur Psychiatry 1999; 14: 217-229
- 13 Hegerl U, Hensch T. The vigilance regulation model of affective disorders and ADHD. Neurosci Biobehav Rev 2014; 44: 45-57
- 14 Gallezzo SR Examining the connection between yawning and depression. http://www.baillement.com/recherche/gallezzo.html2006
- 15 Beale MD, Murphree TM. Excessive yawning and SSRI therapy. Int J Neuropsychopharmacol 2000; 3: 275-276
- 16 Bene J, Bastides M, Auffret M et al. Serotonin and yawning: A possible adverse drug reaction during antidepressant therapy. Presse med (Paris, France: 1983) 2014; DOI: 10.1016/j.lpm.2013.12.018.
- 17 Bertschy G, Vandel S, Sechter D et al. Yawning and sexual excitation under clomipramine. Role of serotoninergic mechanisms. Apropos of 2 cases. Encephale 1991; 17: 515-517
- 18 Chen CH, Lu ML. Venlafaxine-induced excessive yawning. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33: 156-157
- 19 Cohen AJ. Fluoxetine-induced yawning and anorgasmia reversed by cyproheptadine treatment. J Clin Psychiatry 1992; 53: 174
- 20 De Las Cuevas C, Sanz EJ. Duloxetine-induced excessive disturbing and disabling yawning. J Clin Psychopharmacol 2007; 27: 106-107
- 21 Goldberg RL. Sustained yawning as a side of imipramine. Int J Psychiatry Med 1983; 13: 277-280
- 22 Gutierrez-Alvarez AM. Do your patients suffer from excessive yawning?. Acta psychiatrica Scand 2007; 115: 80-81
- 23 Harada K. Paroxetine-induced excessive yawning. Psychiatry Clin Neurosci 2006; 60: 260
- 24 Horgan D. Antidepressant overshoot: the YES syndrome. Aust N Z J Psychiatry 2007; 41: 90-91
- 25 McLean JD, Forsythe RG, Kapkin IA. Unusual side effects of clomipramine associated with yawning. Can J Psychiatry 1983; 28: 569-570
- 26 Modell JG. Repeated observations of yawning, clitoral engorgement, and orgasm associated with fluoxetine administration. J Clin Psychopharmacol 1989; 9: 63-65
- 27 Pae CU, Kim JJ, Lee CU et al. Injured temporomandibular joint associated with fluoxetine-monotherapy-induced repeated yawning. Gen Hosp Psychiatry 2003; 25: 217-218
- 28 Sommet A, Desplas M, Lapeyre-Mestre M et al. Drug-induced yawning: a review of the French pharmacovigilance database. Drug Saf 2007; 30: 327-331
- 29 Pal S, Padala PR. A case of excessive yawning with citalopram. Prim Care Companion J Clin Psychiatry 2009; 11: 125-126
- 30 Nierenberg AA, Greist JH, Mallinckrodt CH et al. Duloxetine versus escitalopram and placebo in the treatment of patients with major depressive disorder: onset of antidepressant action, a non-inferiority study. Cur Med Res Opin 2007; 23: 401-416
- 31 Uher R, Farmer A, Henigsberg N et al. Adverse reactions to antidepressants. Br J Psychiatry 2009; 195: 202-210
- 32 Reference PD. Physicians’ Desk Reference. 65. (ed.). Montvale, NY: Thomson Healthcare; 2011. (December 2010)
- 33 Collins GT, Eguibar JR. Neurophamacology of yawning. Front Neurol Neurosci 2010; 28: 90-106
- 34 Bull SA, Hunkeler EM, Lee JY et al. Discontinuing or switching selective serotonin-reuptake inhibitors. Ann Pharmacother 2002; 36: 578-584
- 35 Cascade E, Kalali AH, Kennedy SH. Real-world data on SSRI antidepressant side effects. Psychiatry (Edgmont) 2009; 6: 16-18
- 36 Papakostas GI. Tolerability of modern antidepressants. J Clin Psychiatry 2008; 69 (Suppl E1) 8-13
- 37 Fava M, Graves LM, Benazzi F et al. A cross-sectional study of the prevalence of cognitive and physical symptoms during long-term antidepressant treatment. J Clin Psychiatry 2006; 67: 1754-1759
- 38 West CH, Ritchie JC, Boss-Williams KA et al. Antidepressant drugs with differing pharmacological actions decrease activity of locus coeruleus neurons. Int J Neuropsychopharmacol 2009; 12: 627-641
- 39 Grant MM, Weiss JM. Effects of chronic antidepressant drug administration and electroconvulsive shock on locus coeruleus electrophysiologic activity. Biol Psychiatry 2001; 49: 117-129
- 40 Schwabe U, Paffrath D. (eds.). Arzneiverordnungs-Report 2013. Berlin, Heidelberg: Springer-Verlag; 2013