A CONTROLLED STUDY OF THE ANTIDEPRESSANT EFFICACY OF SLEEP DEPRIVATION

大约60%的抑郁症患者服用过抗抑郁药 对睡眠剥夺的反应(SD)。然而，使用SD作为一种治疗方法 因为抑郁症一直受到大多数患者复发的事实的限制 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可能的临床应用。首先，使用SD来加速发病 关于氟西汀的作用(第一议定书)。第二，将SD添加到正在进行的 对甲氧西林部分应答的患者的药物治疗 抗抑郁药物治疗，试图加强 药物(第二号议定书)。促甲状腺激素、游离T-3、催乳素和皮质醇水平 在SD前后进行测量，以确定它们的潜力 对SD的抗抑郁作用的再认识。 由于很难为SD设计适当的控制条件，因此 SD文学在很大程度上一直不受控制。本年上半年的特别提款权 夜间(早早睡眠剥夺，ESD)已被证明效果较差 后半夜的睡眠不足(晚睡剥夺，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诊断重度抑郁障碍的标准，或者 双相情感障碍，抑郁。患者被随机分配到ESD或LSD。 方案I中的患者在服用氟西汀前四天开始服用氟西汀 SD的第一个晚上。第二方案中的患者，他们都处于稳定状态 至少六周的用药方案，继续使用该方案 在整个研究过程中。在经历了基准一天的多重情绪评级和 抽血检测荷尔蒙水平，患者被剥夺两次睡眠 连续几个晚上。一周后，两个晚上的睡眠过程 剥夺是反复发生的。然后每周对患者进行跟踪检查 三个星期的情绪评分和重复的血样。

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.