Psychiatric disorders are rarely associated with REM sleep behaviour disorder. (1236) Fluoxetine treatment of obsessive-compulsive disorder,(37) or cessation of use or abuse of REM-suppressing agents (viz. ethanol, amphetamine, cocaine, imipramine(38)) can trigger REM sleep behaviour disorder. Tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and venlafaxine can induce or aggravate REM sleep behaviour disorder. In four cases, major stress involving divorce, automobile accident, sea disaster, or public humiliation triggered REM sleep behaviour disorder. (2,12>
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