title: Hypnotics as concurrent medication in depression. A placebo-controlled, double-blind comparison of flunitrazepam and lormetazepam in patients with major depression, treated with a (tri)cyclic antidepressant.
abstract: The addition of benzodiazepine hypnotics to a treatment with tricyclic antidepressants has received little systematic study. In a double-blind placebo-controlled design, the effects on mood and on sleep of two benzodiazepine hypnotics (lormetazepam and flunitrazepam) were studied in patients with major depression who were also treated with maprotiline or nortriptyline. After 4 weeks of combined treatment, lormetazepam resulted in a significantly greater decrease in the score on the Hamilton Depression Subscale than placebo, while there was a non-significant trend in favour of lormetazepam in comparison with flunitrazepam. With respect to sleep EEGs, lormetazepam resulted in a significantly greater suppression of REM sleep. The differences between lormetazepam and flunitrazepam may be partly explained by the shorter half-live of lormetazepam.
authors.affiliation: Psychiatric Centre Bloemendaal, Department of Biological Psychiatry, The Hague, The Netherlands.
authors.forename: W A
authors.initials: WA
authors.lastname: Nolen
authors.forename: P M
authors.initials: PM
authors.lastname: Haffmans
authors.forename: P F
authors.initials: PF
authors.lastname: Bouvy
authors.forename: H J
authors.initials: HJ
authors.lastname: Duivenvoorden
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D001569:Benzodiazepines; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005445:Flunitrazepam / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008140:Lorazepam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010919:Placebos; D010949:Plasma / Q000187:drug effects; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology; D012895:Sleep, REM / Q000187:drug effects
chemical_list: D014151:Anti-Anxiety Agents; D000929:Antidepressive Agents, Tricyclic; D006993:Hypnotics and Sedatives; D010919:Placebos; D001569:Benzodiazepines; D005445:Flunitrazepam; C023842:lormetazepam; D008140:Lorazepam