Many medications used in pain management have been known to cause weird dreams. Medications that tend to have some effect on the brain can also have an effect on sleep and dreams.

Antidepressants & Muscle Relaxers

The most common medications that impact dreams and sleep are probably antidepressant drugs, followed by muscle relaxers.  These medications have direct actions on the brain and nervous system, and change the balance of brain chemicals that can lead to very odd cognition and disturbing dreams.

The older tricyclic antidepressants have a positive effect on pain but have had a significant reputation for bad dreams.  Newer antidepressants impact the neurotransmitter chemical balance in the brain, and can make emotions, depression, and sleep worse if they are not the right medication for the individual.  Muscle relaxers are compounds that have similar structures to drugs used for anxiety. They can cloud thinking and negatively impact sleep.

Neuropathic Medications

Neuropathic medications are drugs often used to treat pain.  These drugs include many different classes of chemical and all directly affect the central nervous system and the brain in a variety of different ways.  For most people, if prescribed with a degree of caution these drugs can be highly effective for pain.  However, as with any medication that acts on the brain, the side effects can include an alteration of cognition and weird dreams.

At this time, it is very difficult to know if a drug will cause bad dreams without trying it.  If you have had a problem with a medication, similar drugs may cause the same type of problem and should be monitored closely.  Sudden or rapid changes in drug levels can cause some of the problems tolerating certain medications.  Often, if a new drug is started at the lowest available dose, and slowly increased, side effects can be minimized.  It is also equally important to not suddenly stop these drugs to prevent side effects.  Working with an experienced physician with regards to medications is always advisable.  If a problem does occur, ask the prescribing physician to check if there are medications interacting with each other and causing problems.