Does Prozac cause hypnic jerks? (+1 cases)

In this article, we will discuss if Prozac can cause hypnic jerks while sleeping. Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) that is used in the treatment of depressive disorder, obsessive-compulsive disorder (OCD), and anxiety disorder in both children and adults.

Does Prozac cause hypnic jerks?

Yes, Prozac can cause hypnic jerks. Prozac has been linked to hypnic jerks, or sleep starts, which are benign myoclonic jerks that occur as a person falls asleep. However, it is considered a rare side effect of Prozac.

Hypnic jerks are felt as a quick involuntary contraction of the body muscle during sleep. It is important to note hypnic jerks are a frequent psychological phenomenon that 70% of people will experience at least once in a lifetime, with no negative neurological consequences.

Although hypnic jerks are painless, they can cause other sensations like hallucinations, dreams, or involuntary sounds as you fall asleep. Many triggers can cause hypnic jerks, including anxiety, stress, stimulants like caffeine and nicotine, sleep deprivation, and hard physical exercises (1).

What is the link between Prozac and hypnic jerks?

According to the second International Classification of Sleep Disorder (ICSD-2), hypnic jerks are classified as isolated symptoms, seemingly due to normal variables and unresolved issues. They fall on the borderline between normal and abnormal sleep. However, they must be treated if they interfere with sleep or cause a severe decline in quality of life.

One theory suggests that hypnic jerks are a basic protective reaction in which your brain misinterprets the calming effect of Prozac as a warning that the person is falling. The brain then orders the muscles to tense up to protect the person from falling (2).

It is important to know if the patient has previously experienced hypnic jerks before the start of treatment with Prozac. Only then the doctor would be able to establish hypnic jerks to Prozac administration.

What does the clinical data suggest?

In one of the case reports, a female patient with OCD reported brisk jerks in the body and legs whenever she went to sleep. She had no history of such jerks, or limb movement during the duration of her sleep. She also had no daytime tiredness. The only change was the addition of Prozac (20 mg/day) to her treatment regimen. The physicians added Clonazepam (0.5 mg) to her prescription to control hypnic jerks (3).

In another experience shared by a patient with OCD, Prozac (60 mg/day) caused hypnic jerks and sleep abnormalities. However, after 5th week, the hypnic jerks began to fade away and the sleeping pattern also improved. This signifies that hypnic jerks can be an early symptom of Prozac treatment in a few patients. With time, the body adjusts to SSRI and the side effects also reduce.

In another medical blog, Prozac users have described the occurrence of hypnic jerks once they started taking Prozac. They have reported feeling of falling and muscle twitching once they go to sleep. This has altered their sleeping patterns.

How to reduce the occurrence of hypnic jerks?

There is no definite treatment for hypnic jerks. The person experiencing hypnic jerks cannot control it during the sleep cycle. Clonazepam is found to be effective in reducing hypnic jerks caused by Prozac. In addition, a few lifestyle modifications can help to reduce the occurrence of Prozac-induced hypnic jerks.

Prozac-induced hypnic jerks should be reported to the healthcare professional especially if it interferes with sleep. Clonazepam is found to be effective in reducing hypnic jerks associated with Prozac. Besides that, the following precautions should be taken:

  • Avoid caffeine: Reduce caffeine intake and avoid coffee up to six hours before bedtime. The stimulating effects of caffeine can cause hypnic jerks and make it more difficult to fall asleep (4).
  • Avoid alcohol: Alcohol has been linked to hypnic jerks, sleep apnea, insomnia, and abnormalities in circadian rhythm (5).
  • Exercise: Excessive exercise an hour before bedtime is likely to interfere with sleep. The chance of hypnic jerks may then rise as a result of this disturbed sleep (6).
  • Screen time: Blue light from devices and cell phones can prevent the body from producing melatonin naturally. This can make it more difficult to fall asleep (7).


We discussed the possibility of Prozac-induced hypnic jerks and how it can affect your life and sleeping patterns. We also discussed the pharmacological intervention and other lifestyle changes that can reduce the occurrence of hypnic jerks.

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Sathe H, Karia S, Desousa A, Shah N. Hypnic jerks possibly induced by escitalopram. Journal of Neurosciences in Rural Practice. 2015 Mar;6(03):423-4.


Vetrugno R, Montagna P. Sleep-to-wake transition movement disorders. Sleep Medicine. 2011 Dec 1;12:S11-6.


Kumar R, Ali SN, Saha S, Bhattacharjee S. SSRI induced hypnic jerks: A case series. Indian Journal of Psychiatry. 2023 Jul 1;65(7):785-8.,common%20with%20all%20SSRI%20medication.


Drake C, Roehrs T, Shambroom J, Roth T. Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. Journal of Clinical Sleep Medicine. 2013 Nov 15;9(11):1195-200.


He S, Hasler BP, Chakravorty S. Alcohol and sleep-related problems. Current opinion in psychology. 2019 Dec 1;30:117-22.


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