Comparison of effects of desipramine and amitriptyline on EEG sleep of depressed patients

Abstract:The sleep electroencephalogram (EEG) provides biomarkers of depression, which may help with diagnosis, prediction of therapy response, and prognosis in the treatment of depression. In patients with depression, characteristic sleep EEG changes include impaired sleep continuity, disinhibition of rapid-eye-movement (REM) sleep, and impaired non-REM sleep. Most antidepressants suppress REM sleep in depressed patients, healthy volunteers, and in animal models. REM suppression appears to be an important, but not an absolute requirement, for antidepressive effects of a substance. Enhanced REM density, a measure for frequency of REM, characterizes high-risk probands for affective disorders. REM-sleep changes were also found in animal models of depression. Sleep-EEG variables were shown to predict the response to treatment with antidepressants. Furthermore, certain clusters of sleep EEG variables predicted the course of the disorder for several years. Some of the predicted sleep EEG markers appear to be related to hypothalamic-pituitary-adrenal system activity.

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“…84 A weak adaptation was found, however, after administration of tricyclic antidepressants. 85,86 The reversible …”

Section: Sleep Eeg Changes After Antidepressants In Patients and Healmentioning

confidence: 99%

Sleep electroencephalography as a biomarker in depression

Steiger¹,

Pawlowski²,

Kimura³

2015

CPT

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“…Future studies might test alternative treatment strategies for patients with depression complicated by persistent insomnia. Although tricyclic antidepressants (TCAs) have been largely replaced by newer drug classes because of their autonomic and cardiovascular side effects, their ability to improve not only insomnia (Haskell et al 1975;Vaisanen et al 1978;Young et al 1976), but also sleep quality (Buysse et al 1996;Feuillade et al 1992;Hajak et al 2001;Roth et al 1982;Shipley et al 1985) is well established. "Second-generation" sedating antidepressants trazodone and nefazodone (Manber et al 2003;Thase et al 2002) also improve sleep quality and provide another antidepressant monotherapy option for these patients, although their benefits need to be weighed against possible cardiovascular side effects of trazodone and the risk of hepatic failure, which resulted in the boxed warning for nefazodone.…”

Section: Treatment Implicationsmentioning

confidence: 99%

Which symptoms predict recurrence of depression in women treated with maintenance interpersonal psychotherapy?

Dombrovski¹,

Cyranowski²,

Mulsant³

et al. 2008

Depress. Anxiety

104

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Background-Even low levels of residual symptoms are known to increase the risk of relapse and early recurrence of major depression. It is not known if ongoing psychotherapy lessens this risk. We therefore examined the impact of persistent symptoms, including mood, insomnia, and anxiety symptoms, on time to recurrence in women receiving maintenance interpersonal psychotherapy (IPT-M) for recurrent depression.

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“…Our main hypothesis was that duloxetine would show a typical antidepressant sleep EEG profile, particularly regarding REM sleep. Desipramine, a specific NE reuptake inhibitor with minimal effect on 5-HT reuptake (Owens et al 1997) associated with suppression of REM sleep (Shipley et al 1985), was used as positive control. Since the study was primarily designed to document pharmacodynamic effects of duloxetine in non-depressed subjects, the duration of treatment was based on pharmacokinetic considerations.…”

Section: Introductionmentioning

confidence: 99%