A CONTROLLED STUDY OF THE ANTIDEPRESSANT EFFICACY OF SLEEP DEPRIVATION

睡眠剥夺抗抑郁功效的对照研究

• 批准号: 3880992
• 负责人: E LEIBENLUFT
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3880992
• 关键词: antidepressants; bipolar depression; cortisol; human subject; human therapy evaluation; mental disorder chemotherapy; prolactin; psychopharmacology; sleep deprivation; thyrotropin

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.

大约 60% 的抑郁症患者正在接受抗抑郁药物治疗 对睡眠剥夺（SD）的反应。然而，使用SD作为治疗 由于大多数患者都会复发，因此对抑郁症的治疗受到限制 经过一晚的恢复性睡眠后。这项研究测试了两种方法的功效 SD 的可能临床应用。首先，使用SD来加速起效 氟西汀的作用（方案 I）。其次，SD被添加到正在进行的 对药物治疗有部分反应的患者 抗抑郁药物试图增强效果 药物治疗（议定书 II）。 TSH、游离 T-3、催乳素和皮质醇水平 在 SD 之前和之后进行测量，以确定它们的潜力 尊重SD的抗抑郁作用。 由于很难为 SD 设计适当的控制条件，因此 SD 文学基本上不受控制。 SD上半年 夜间睡眠（早期睡眠剥夺，ESD）已被证明效果较差 后半夜的睡眠时间比 SD 晚（晚期睡眠剥夺，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 重度抑郁症标准，或 双相情感障碍，抑郁。患者被随机分配接受 ESD 或 LSD。 方案一中的患者在就诊前四天开始服用氟西汀 SD的第一个晚上。方案 II 中的患者均处于稳定状态 药物治疗至少六周，并继续该治疗方案 整个研究过程中。经过一天的多个情绪评分的基线后 抽血检查荷尔蒙水平，患者睡眠不足两年 连续几个晚上。一周后，两晚睡眠的过程 剥夺不断重复。然后每周对患者进行随访 三周的情绪评级和重复的血液样本。