ABSTRACT
Fluoxetine (60 mg), a selective inhibitor of the reuptake of 5-HT, was compared in a double-blind trial to amitriptyline (150 mg) in a sample of 34 patients fitting the Research Diagnostic Criteria for a major depressive disorder. Patients were studied after a drug washout period of 10 days and an active treatment period of 42 days. Sleep polygraphic recordings were performed before and at the end of the study. As indicated by the significant decrease in the Hamilton Depression scale and the Montgomery Asberg Depression scale, fluoxetine showed similar antidepressant effects to amitriptyline with significantly fewer adverse effects. Fluoxetine and amitriptyline decreased the amount of REM sleep, a well known effect of classical antidepressants. Fluoxetine showed some specific effects on sleep continuity (potentially dose related) as indicated by the significant increase in the number of awakenings and in stage shifts, without interfering with the therapeutic response.
Subject(s)
Depression/drug therapy , Fluoxetine/therapeutic use , Sleep/drug effects , Adolescent , Adult , Amitriptyline/therapeutic use , Depression/psychology , Female , Fluoxetine/adverse effects , Humans , Male , Middle Aged , Psychiatric Status Rating ScalesABSTRACT
Sleep polygraphic recordings were performed in six unmedicated male manics, in age and sex matched unipolar and bipolar depressives and in normal controls. No difference was evidenced between manics, depressives and controls when percentages of sleep stages 1, 2, 3, 4 and REM were considered. Manics demonstrated poorer sleep efficiency, longer sleep onset latency and reduced sleep period time than normal controls but no more so than in our depressed patients. None of the classical sleep disturbances reported in depression (short REM latency, decreased delta sleep and increased REM density) were observed in mania suggesting that with the exception of sleep continuity disturbances, sleep in mania is comparable to sleep in normal subjects.
