Effects of sertraline on sleep architecture in patients with depression
Effects of sertraline on sleep architecture in patients with depression
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DOI：
10.1097/01.jcp.0000095345.32154.9a
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发表时间：
2003-12-01
影响因子：
2.9
通讯作者：
Thase, ME
中科院分区：
文献类型：
--
作者：
Jindal, RD;Friedman, ES;Thase, ME
先前的研究表明，选择性5-羟色胺再摄取抑制剂（SSRIs），包括氟西汀，氟伏沙明，西酞普兰和帕罗西汀，抑制快速眼动睡眠，并增加夜间觉醒。目前还没有关于舍曲林对抑郁症患者睡眠影响的报道。本研究探讨了这种影响。47例重度抑郁症患者随机接受舍曲林或安慰剂双盲治疗，在药物治疗12周前后完成睡眠研究。使用多变量协方差分析和/或协方差分析比较各组，以检查4组经验定义的睡眠指标。与安慰剂治疗组相比，接受舍曲林治疗的患者在第一个睡眠周期中的δ波睡眠增加，快速眼动（REM）睡眠潜伏期延长。虽然舍曲林治疗减少了REM期的平均数量（从3.86到2.40），但REM期1和REM期2的活动都显著增加。除了增加睡眠潜伏期外，舍曲林治疗与睡眠连续性指标恶化无关。在主观嗜睡的测量上，两组之间也没有显著差异。这些发现与以前其他SSRI研究中观察到的结果既相似又不同。δ睡眠比率的增加和快速眼动睡眠的巩固可能具有其他一些临床意义。然而，由于一些原因，这些研究结果的普遍性是有限的。SSRIs对重度失眠抑郁症患者的急性治疗效果以及急性变化与复发性抑郁症复发预防的关系有待进一步研究。
Previous studies indicate that selective serotonin reuptake inhibitors (SSRIs), including fluoxetine, fluvoxamine, citalopram and paroxetine, suppress rapid eye movement sleep, and increase nocturnal arousals. There has been no published report of the impact of sertraline on the sleep of depressed patients. This study examines such effects. Forty-seven patients with major depressive disorder, randomized to double-blind treatment with sertraline or placebo, completed sleep studies before and after 12 weeks of pharmacotherapy. Groups were compared using multivariate analyses of covariance and/or analyses of covariance to examine 4 empirically defined sets of sleep measures. Compared to the placebo-treated group, patients who received sertraline experienced an increase in delta wave sleep in the first sleep cycle and prolonged rapid eye movement (REM) sleep latency. Although, sertraline therapy decreased the average number of REM periods (from 3.86 to 2.40), the activity of both REM period 1 and REM period 2 was significantly increased. Aside from an increase in sleep latency, sertraline therapy was not associated with a worsening of measures of sleep continuity. There was also no significant difference between the groups on a measure of subjective sleepiness. These findings are both similar and different from those observed in previous studies of other SSRIs. The increase in delta sleep ratio and consolidation of REM sleep may have some other clinical implications. However, the generalizability of these findings is limited because of a number of reasons. Further studies are needed to examine the effects of SSRIs in acute treatment of depressed patients with severe insomnia, and the relationship of acute changes and relapse prevention of recurrent depression.