A CONTROLLED STUDY OF THE ANTIDEPRESSANT EFFICACY OF SLEEP DEPRIVATION

大约60%的抑郁症患者使用抗抑郁药 睡眠剥夺（SD）。然而，使用SD作为治疗 因为大多数病人会复发 经过一夜的恢复睡眠后这项研究测试了两种药物的疗效。 SD的可能临床应用首先，SD用于加速发作 氟西汀的作用（方案I）。其次，SD被添加到正在进行的 部分缓解的患者的药物治疗 抗抑郁药物，试图加强的影响， 药物（第二号议定书）。TSH、游离T-3、催乳素和皮质醇水平 在SD前后测量，以确定其潜力 对SD抗抑郁作用的影响。 由于很难为SD设计一个适当的控制条件， SD文献在很大程度上是不受控制的。上半年SD 夜间睡眠（早期睡眠剥夺，ESD）已被证明是不太有效的 在后半夜的睡眠剥夺（LSD）。 因此，我们使用ESD作为LSD的控制条件。 患者必须符合DSM-III-R的重度抑郁症标准，或 躁郁症抑郁症患者被随机分配到ESD或LSD组。 方案I中的患者在其治疗前4天开始氟西汀治疗。 SD的第一天方案二中的患者，他们都在稳定的 药物治疗方案至少六周，继续该方案 在整个研究中。经过一天的多个情绪评级基线， 血液采样激素水平，病人被剥夺睡眠两个 连续几个晚上一周后，两个晚上的睡眠过程 剥夺是重复的。然后每周对患者进行随访， 三周的情绪评估和重复的血液样本

Approximately 60% of depressed patients experience an antidepressant response to sleep deprivation (SD). However, the use of SD as a treatment for depression has been limited by the fact that most patients relapse after a night of recovery sleep. This study tests the efficacy of two possible clinical applications of SD. First, SD is used to hasten the onset of action of fluoxetine (Protocol I). Second, SD is added to the ongoing pharmacotherapy of patients who have had a partial response to antidepressant medication in an attempt to potentiate the effect of the medication (Protocol II). Levels of TSH, free T-3, prolactin, and cortisol are measured before and after SD, in order to determine their potential rerevence to SD's antidepressant effect. Since it is difficult to design an adequate control condition for SD, the SD literature has been largely uncontrolled. SD in the first half of the night (early sleep deprivation, ESD) has been shown to be less effective than SD in the second half of the night (late sleep deprivation, LSD). Therefore, we use ESD as a control condition for LSD. Patients must meet DSM-III-R criteria for major depressive disorder, or for bipolar disorder, depressed. Patients are randomly assigned to ESD or LSD. Patients in Protocol I are started on fluoxetine four days before their first night of SD. Patients in Protocol II, who have all been on a stable regimen of medication for at least six weeks, are continued on that regimen throughout the study. After a baseline day of multiple mood ratings and blood sampling for hormonal levels, patients are sleep deprived for two nights in a row. One week later, the course of two nights of sleep deprivation is repeated. Patients are then followed on a weekly basis for three weeks with mood ratings and repeated blood samples.