The Effects of Nefazodone on Sleep Architecture in Depression

Armitage, Roseanne; Rush, A. John; Trivedi, Madhukar H.; Cain, John W.; Roffwarg, Howard P.

doi:10.1038/npp.1994.14

Cited by 90 publications

(49 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This clinical analysis confirmed earlier PSG investigations by Armitage et al [25] showing decreased nocturnal wakefulness and arousals after 4-8 weeks of nefazodone, 400-600 mg/day, with an increase in S2, decrease in S1 and a lack of significant REM changes.…”

Section: Findings In Patientssupporting

confidence: 79%

Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality

2000

View full text Add to dashboard Cite

The purpose of this paper is to review the effects of selective serotonin (5-HT) reuptake inhibitors on objective and subjective sleep and awakening quality measures. Polysomnography (PSG) demonstrated in both healthy volunteers and depressed patients a decrease in sleep efficiency and total sleep time, a lengthening of sleep latency and a deterioration in sleep continuity, including an increase in the number of awakenings and wake time during the total sleep period. Sleep architecture mostly showed an increase in S1 and S2 and a decrease in S3, S4 and REM sleep as well as a lengthening of REM latency. Objective awakening quality, if measured at all by psychometry, generally showed no decrements. Concerning subjective sleep and awakening quality, normals demonstrated either no changes or a tendency towards a deterioration, while in patients some improvement was observed. Reasons for this discrepancy will be discussed. Novel 5-HT reuptake inhibitors with additional modes of action such as 5-HT2 antagonism (e.g. trazodone, nefazodone) are more likely to improve objective and subjective sleep quality, although some shortcomings may be inherent in regard to comorbidity (e.g. sleep-related breathing disorders). Thus, PSG seems to be a necessity for diagnosis and treatment of complex sleep disorders.

show abstract

Section: Findings In Patientssupporting

confidence: 79%

Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality

2000

View full text Add to dashboard Cite

show abstract

“…However, not all antidepressants reduce REM sleep (18)(19)(20). Moreover, antidepressant effects are not restricted to REM sleep; they also include alterations in sleep consolidation and sleep architecture that may be relevant both to clinical response and to the need for concomitant or augmentive treatment.…”

Section: Antidepressant Effects On Sleep In Patients With Depressionmentioning

confidence: 99%

“…Trazodone and nefazodone both affect serotonergic neurotransmission but are pharmacologically distinct from the SSRIs (and from each other) (19,30). Their effects on sleep also differ dramatically from the SSRIs.…”

Section: Other Serotonergic Antidepressantsmentioning

confidence: 99%

“…Nefazodone may also be unique in that it does not appear to suppress REM sleep in either healthy controls or in patients with depression (19,68,30). In an open-label preliminary study of the effect of 400 mg to 600 mg (200 mg to 300 mg twice daily) of nefazodone on sleep in 10 patients with depression, Armitage and others reported decreased awake and movement time and short duration arousals, as well as increased stage 2 sleep, but noted minimal effects on REM sleep (19). Trends toward decreased stage I sleep were also found.…”

Section: Other Serotonergic Antidepressantsmentioning

confidence: 99%

See 1 more Smart Citation

The Effects of Antidepressants on Sleep in Patients with Depression

Armitage

2000

Can J Psychiatry

Self Cite

View full text Add to dashboard Cite

As assessed by laboratory studies, sleep abnormalities in those with major depressive disorders can be classified as difficulties initiating and maintaining sleep, abnormal sleep architecture, and disruptions in the timing of rapid eye movement (REM) sleep. Sleep initiation and maintenance difficulties include prolonged sleep latency (sleep onset insomnia), intermittent wakefulness and sleep fragmentation during the night, early morning awakenings with an inability to return to sleep, reduced sleep efficiency, and decreased total sleep time. With regard to sleep architecture, abnormalities have been reported in the amounts and distribution of nonrapid eye movement (NREM) sleep stages across the night. These include increased light, stage 1 sleep and reductions in the amount ofdeep, slow-wave (stages 3 and 4) sleep. REM sleep disturbances in patients with depression include a short latency (65 minutes) to the first REM sleep, a prolonged first REM sleep period, and increased total REM sleep time, particularly in the first one-half of the night (1-3).Sleep disturbances are generally more prevalent among inpatients with depression (80%), whereas only 40% to 60% of outpatients show sleep abnormalities (4). A recent metaanalysis, however, indicated that no single sleep variable reliably distinguished patients with depression from healthy controls Manuscript

show abstract

“…Several sleep variables were derived from the scored polysomnographic (PSG) data. See Armitage et al [36] for computational detail. Briefly, persistent sleep latency (first 10 minutes of any stage with no more than 2 minutes of awake), the total sleep period (from sleep onset to wake-up time) sleep efficiency (the ratio of total sleep period to time in bed x 100) REM latency (with no minimum duration criterion) and the percentages of each of stages 1-4, REM and awake were computed relative to the total sleep period.…”

Section: Never-depressed Healthy Controlsmentioning

confidence: 99%

Sleep Macroarchitecture in Depression: Sex Differences~!2009-11-01~!2010-03-01~!2010-04-21~!

Swanson¹,

Armitage²

2010

TOSLPJ

Self Cite

View full text Add to dashboard Cite

Abstract:Background: Although the relationship between sleep and depression has been studied over the past two decades, findings are inconsistent across the literature. The present study evaluated differences in sleep macroarchitecture between adults with major depressive disorder (MDD) and healthy controls, paying particular attention to sex differences.Method: Sleep macroarchitecture was investigated in 129 adults symptomatic with MDD compared to 62 never-depressed healthy controls. Participants were free of psychiatric medications and were required to maintain a set sleep schedule for the 5 days prior to study.Results: Prolonged sleep latency and increased REM density were observed in participants with MDD relative to healthy controls, but REM latency was longer and there were fewer arousals in the MDD group. Regression analysis differentiated between MDD and HC groups, but only in men. Sex differences were also found in the relationship between clinical course of MDD and sleep variables with stronger correlations between sleep, age of onset and MDD severity in men than in women.Conclusions: Sex differences were observed in the relationship between clinical course of depression and sleep and in differentiating patients form healthy controls, supporting a different pathophysiology of depression in men and women.

show abstract

The Effects of Nefazodone on Sleep Architecture in Depression

Cited by 90 publications

References 10 publications

Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality

Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality

The Effects of Antidepressants on Sleep in Patients with Depression

Sleep Macroarchitecture in Depression: Sex Differences~!2009-11-01~!2010-03-01~!2010-04-21~!

Contact Info

Product

Resources

About