Based on the case study below, evaluate the appropriateness of immediately prescribing a pharmacological treatment (such as a benzodiazepine or antidepressant) as the primary and sole intervention. Justify your clinical reasoning.

Evaluating Treatment for Complex Sleep-Related Behaviors

Somnambulism has historically been treated with medications, including benzodiazepines and antidepressants, but the effectiveness of these pharmacological treatments is uncertain. In Guilleminault et al. (2005), benzodiazepines did not alleviate sleepwalking.

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Also known as somnambulism, sleepwalking is a parasomnia where an individual performs complex actions, such as wandering or even driving a car, while asleep. Although their eyes are often open during these episodes, they are unresponsive to communication. This behavior most frequently occurs during slow-wave sleep, though it can happen at any point in the sleep cycle for some individuals.

Sleepwalking (Somnambulism)

Spielman, R. M., Jenkins, W. J., & Lovett, M. D. (2020, April 22). Psychology (2nd ed.). OpenStax. https://openstax.org/books/psychology-2e/pages/1-introduction

OpenStax Psychology (2nd ed.) Textbook

Pharmacological Treatments for Somnambulism

In Guilleminault et al. (2005), somnambulistic patients who also had sleep-related breathing problems showed a marked decrease in sleepwalking when those breathing problems were effectively treated.

Effect of Treating Sleep-Related Breathing Problems on Somnambulism

Although it is an extremely rare phenomenon, many sleep researchers and experts believe that it is possible for individuals with certain sleep disorders to commit violent acts, including homicide, during a sleepwalking episode.

Scientific View on Homicidal Somnambulism

The case of Scott Falater is a prominent example of alleged homicidal somnambulism. On January 16, 1997, Falater was arrested for murdering his wife, Yarmila, who was found in their pool with 44 stab wounds. Falater claimed no memory of the event. Evidence included a neighbor's testimony, blood-stained clothes, and a knife. Despite a lack of motive and support from family who described the marriage as excellent, Falater had a history of childhood sleepwalking, including one violent episode toward his sister. He had no other diagnosed psychological disorders or brain abnormalities. He used sleepwalking as his defense, but a jury found him guilty of first-degree murder in 1999.

Overview of the Scott Falater Homicidal Somnambulism Case

A defendant is on trial for a violent crime. He claims he has no memory of the event and must have been sleepwalking, a defense his lawyer is using in court. You are a sleep expert asked to consult on the case. Based on the established characteristics of sleepwalking (a sleep disorder involving complex behaviors while asleep, with the individual being unresponsive and typically having no memory of the event), evaluate the credibility of the defendant's claim using the information below. Justify your conclusion by analyzing which aspects of the case support his claim and which aspects challenge it.

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