Sleep cluster arousal analysis and treatment response to heterocyclic antidepressants in patients with major depression.
BACKGROUND
A close link between sleep normalisation and antidepressant response in depressed patients has been reported. We attempt to separate early antidepressant treatment responders from nonresponders by the use of sleep EEG recordings.


METHODS
Sleep EEG recordings were performed in 20 inpatients with a unipolar major depressive disorder during the first and third week of treatment with heterocyclic antidepressants. Acute treatment polygraphic measures with microarousal analysis were used to predict response. Response was defined as a minimum reduction of > or = 30% in the v. Zerssen Depression Scale after 3 weeks.


RESULTS
Compared to the 11 nonresponders, the 9 responders initially showed a highly significant increase of arousals during sleep quantified with the cluster disturbed sleep (CDS), whereas the classical sleep parameters (REM, stage I-IV) had no predictive value.


CONCLUSIONS
The validity of our results is limited by the small number of patients and the lacking randomised assignment. Nevertheless the results are still interesting. Because the CDS clearly separated responders from nonresponders at treatment onset. This could be due to a different reagibility of the catecholaminergic system. The data indicate that the CDS can be helpful for the prediction of early antidepressant treatment response.
Staedt
J
J
Department of Psychiatry, Georg August University, Göttingen, Germany.
Hünerjäger
H
H
Rüther
E
E
Stoppe
G
G
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004569:Electroencephalography / Q000145:classification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome
D000928:Antidepressive Agents