title: Mirtazapine, but not fluvoxamine, normalizes the blunted REM sleep response to clonidine in depressed patients: implications for subsensitivity of alpha(2)-adrenergic receptors in depression.
abstract: To determine whether alpha(2)-adrenergic receptor (alpha2AR) subsensitivity is a state or a trait marker of depression, we consecutively challenged 32 drug-free depressed patients with a clonidine REM suppression test (CREST). We then treated the patients with fluvoxamine, a selective serotonin reuptake inhibitor, or mirtazapine, a selective alpha(2)-adrenergic receptor antagonist. The first 10 patients from each treatment group who recovered were given a second challenge test. The CREST values of the two treatment groups at each time point were compared, and also compared with the CREST values of a group of 10 normal subjects. Before treatment, the REM sleep response to clonidine in the two groups of patients was significantly blunted compared with the REM sleep response in the healthy subjects. After treatment, there was still an abnormal REM sleep response to clonidine in the fluvoxamine-treated patients, despite clinical recovery, but there was a normalized REM sleep response in the mirtazapine-treated patients. These results are compatible with the hypothesis that alpha2AR subsensitivity is a trait marker of depression and suggest that the effects of these two antidepressants on alpha2AR sensitivity may not be linked to the alleviation of depression.
authors.affiliation: Department of Psychiatry, Van Gogh Hospital, Rue de l'Hôpital, 55, B-6030, Marchienne, Belgium. biblio.fsvg@skynet.be
authors.forename: Michel
authors.initials: M
authors.lastname: Schittecatte
authors.forename: Françoise
authors.initials: F
authors.lastname: Dumont
authors.forename: Robert
authors.initials: R
authors.lastname: Machowski
authors.forename: Eric
authors.initials: E
authors.lastname: Fontaine
authors.forename: Catherine
authors.initials: C
authors.lastname: Cornil
authors.forename: Julien
authors.initials: J
authors.lastname: Mendlewicz
authors.forename: Jean
authors.initials: J
authors.lastname: Wilmotte
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000009:adverse effects*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003000:Clonidine / Q000009:adverse effects* / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D016666:Fluvoxamine / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D008803:Mianserin / Q000031:analogs & derivatives* / Q000494:pharmacology* / Q000627:therapeutic use*; D000078785:Mirtazapine; D018341:Receptors, Adrenergic, alpha-2 / Q000187:drug effects*; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D012895:Sleep, REM / Q000187:drug effects*
chemical_list: D000316:Adrenergic alpha-Agonists; D000929:Antidepressive Agents, Tricyclic; D003000:Clonidine; D016666:Fluvoxamine; D008803:Mianserin; D000078785:Mirtazapine; D018341:Receptors, Adrenergic, alpha-2; D017367:Selective Serotonin Reuptake Inhibitors