Effects of Fluoxetine on the Polysomnogram in Outpatients with Major Depression

Trivedi, Madhukar H.

doi:10.1016/s0893-133x(98)00131-6

Cited by 59 publications

(34 citation statements)

References 33 publications

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“…Disturbances in the rapid eye movement (REM) phase of sleep are characteristic of depressive patients, and it has been demonstrated that chronic administration of fluoxetine can improve this defect [76]. Interestingly, similar findings were obtained in preclinical research, where both acute [77] and chronic administrations of fluoxetine were effective in decreasing REM sleep in rodents [78].…”

Section: Effect On Depressive-like Behaviourmentioning

confidence: 60%

Fluoxetine: a case history of its discovery and preclinical development

Pérez-Caballero

Torres-Sánchez

Bravo

et al. 2014

Expert Opinion on Drug Discovery

136

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Section: Effect On Depressive-like Behaviourmentioning

confidence: 60%

Fluoxetine: a case history of its discovery and preclinical development

Pérez-Caballero

Torres-Sánchez

Bravo

et al. 2014

Expert Opinion on Drug Discovery

136

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“…This finding is perhaps not surprising, as there are studies using objective polysomnographic indices finding that a proportion of SSRI-treated patients experience a disturbance of their sleep, 68 and these objective sleep problems can last as long as 30 weeks after SSRI discontinuation. [68][69][70][71] Thus, there were subjective improvements reported by many of those on antidepressants but an objective worsening if the antidepressant was paired with sleep hygiene (i.e., CBT-I was not used). Given the widespread use and belief that sleep hygiene is effective, 57 this finding suggests antidepressants should not be augmented with sleep hygiene if improved objective sleep is desired.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Behavioral Insomnia Therapy for Those With Insomnia and Depression: A Randomized Controlled Clinical Trial

Carney

Edinger

Kuchibhatla

et al. 2017

Sleep

157

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Study Objective: To compare cognitive behavioral therapy for insomnia (CBT-I) + antidepressant medication (AD) against treatments that target solely depression or solely insomnia. Design: A blinded, randomized split-plot experimental study. Setting: Two urban academic clinical centers. Participants: 107 participants (68% female, mean age 42 ± 11) with major depressive disorder and insomnia. Interventions: Randomization was to one of three groups: antidepressant (AD; escitalopram) + CBT-I (4 sessions), CBT-I + placebo pill, or AD + 4-session sleep hygiene control (SH). Measurements and Results: Subjective sleep was assessed via 2 weeks of daily sleep diaries (use of medication was covaried in all analyses); although there were no statistically significant group differences detected, all groups improved from baseline to posttreatment on subjective sleep efficiency (SE) and total wake time (TWT) and the effect sizes were large. Objective sleep was assessed via overnight polysomnographic monitoring at baseline and posttreatment; analyses revealed both CBT groups improved on TWT (p = .03), but the AD + SH group worsened. There was no statistically significant effect for PSG SE (p = .07). There was a between groups medium effect observed for the AD + SH and CBT + placebo group differences on diary TWT and both PSG variables. All groups improved significantly from baseline to posttreatment on the Hamilton Rating Scale for Depression (HAMD-17); the groups did not differ. Conclusions: Although all groups self-reported sleeping better after treatment, only the CBT-I groups improved on objective sleep, and AD + SH's sleep worsened. This suggests that we should be treating sleep in those with depression with an effective insomnia treatment and relying on self-report obscures sleep worsening effects. All groups improved on depression, even a group with absolutely no depression-focused treatment component (CBT-I + placebo). The depression effect in CBT-I only group has been reported in other studies, suggesting that we should further investigate the antidepressant properties of CBT-I.

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“…This effect was still significant when controlling for maternal mood and comparing antidepressant-exposed children to children born to women with major depressive disorder (Casper et al, 2003). Sleep has also been considered to be modulated by prenatal SRI exposure, because a known side effect of current SSRI use is disruption of normal sleep patterns (Sharpley and Cowen, 1995;Trivedi et al, 1999). A study using median and higher doses of SRIs observed increased fetal motor activity in first and second trimesters compared with control or unmedicated, depressed mothers.…”

Section: H Behavioral Studies In Neonates and Childrenmentioning

confidence: 99%