Reduced REM latency predicts response to tricyclic medication in depressed outpatients.
Forty-two outpatients with major depressive disorder entered a double-blind, randomized trial of either desipramine or amitriptyline for a minimum of 6 weeks. Pretreatment polysomnographic and clinical measures were used to predict response. Response was defined as a 17-item Hamilton Rating Scale for Depression score less than or equal to 9 at the end of treatment. There was a 61.1% response rate for patients treated with amitriptyline and a 66.7% response rate for patients treated with desipramine. Reduced REM latency (2-night mean less than or equal to 65.0 min) predicted a positive response to these tricyclic antidepressants. REM latency did not differentiate between desipramine or amitriptyline responders. More patients with reduced REM latency (80%) responded to treatment compared with patients with nonreduced REM latency (50%). The 80% response rate in reduced REM latency depressed patients confirms our previous findings in a mixed inpatient and outpatient sample. Contrary to our hypothesis, in this sample, endogenous depression was not associated with a good response to tricyclic medication.
Rush
A J
AJ
Mental Health Clinical Research Center, University of Texas Southwestern Medical Center at Dallas 75235.
Giles
D E
DE
Jarrett
R B
RB
Feldman-Koffler
F
F
Debus
J R
JR
Weissenburger
J
J
Orsulak
P J
PJ
Roffwarg
H P
HP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D003891:Desipramine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D011897:Random Allocation; D011930:Reaction Time / Q000187:drug effects*; D012895:Sleep, REM / Q000187:drug effects*
D000639:Amitriptyline; D003891:Desipramine