title: Maintenance nortriptyline effects on electroencephalographic sleep in elderly patients with recurrent major depression: double-blind, placebo- and plasma-level-controlled evaluation.
abstract: Our aim was to contrast the effects of maintenance nortriptyline and placebo on electroencephalographic sleep measures in elderly recurrent depressives who survived 1-year without recurrence of depression. Patients on nortriptyline took longer to fall asleep and did not maintain sleep better than patients on placebo; however, maintenance nortriptyline was associated with more delta-wave production and higher delta-wave density in the first non-REM (NREM) period relative to the second. Nortriptyline levels were positively but weakly related to all-night delta-wave production during maintenance (accounting for 6.6% of the variance in delta-wave counts). Total phasic REM activity increased 100% under chronic nortriptyline relative to placebo, with a robust increase in the rate of REM activity generation across the night. Effective long-term pharmacotherapy of recurrent major depression is associated with enhancement in the rate of delta-wave production in the first NREM period (i.e., delta sleep ratio) and of REM activity throughout the night.
authors.affiliation: Mental Health Clinical Research Center for the Study of Late-Life Mood Disorders, University of Pittsburgh Medical Center, Pennsylvania, USA.
authors.forename: C F
authors.initials: CF
authors.lastname: Reynolds
authors.forename: D J
authors.initials: DJ
authors.lastname: Buysse
authors.forename: D P
authors.initials: DP
authors.lastname: Brunner
authors.forename: A E
authors.initials: AE
authors.lastname: Begley
authors.forename: M A
authors.initials: MA
authors.lastname: Dew
authors.forename: C C
authors.initials: CC
authors.lastname: Hoch
authors.forename: M
authors.initials: M
authors.lastname: Hall
authors.forename: P R
authors.initials: PR
authors.lastname: Houck
authors.forename: S
authors.initials: S
authors.lastname: Mazumdar
authors.forename: J M
authors.initials: JM
authors.lastname: Perel
authors.forename: D J
authors.initials: DJ
authors.lastname: Kupfer
mesh_terms: D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000097:blood / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004569:Electroencephalography / Q000187:drug effects*; D006801:Humans; D009661:Nortriptyline / Q000097:blood / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D012890:Sleep / Q000187:drug effects*; D012895:Sleep, REM / Q000187:drug effects
chemical_list: D000929:Antidepressive Agents, Tricyclic; D009661:Nortriptyline