Effects of reboxetine on sleep and nocturnal cardiac autonomic activity in patients with dysthymia.
Antidepressants may have sleep and autonomic side-effects. The acute and long-term effect of reboxetine (2 mg b.i.d.) on sleep and cardiac autonomic activity was compared with that of placebo in a single-blind study. Twelve patients affected by dysthymia underwent four polysomnographic studies at baseline (placebo); at night 3 (reboxetine; acute effect); at night 9 (reboxetine; intermediate-term effect); and at night 122 (reboxetine; chronic effect). After the first administration, reboxetine increased time awake after sleep onset, number of awakenings, percentage of stages 1 and 2 non-rapid eye movement (REM), and reduced the amount of stages 3-4 non-REM, but all these effects disappeared by continuing treatment. However, reboxetine caused a persistent suppression of REM sleep, which was accompanied by an increase of REM sleep latency. The spectral analysis of heart rate variability showed a trend towards an increase in sympathetic activity with both acute and intermediate reboxetine use. Long-term treatment with 4 mg reboxetine does not cause significant changes in cardiac autonomic function.
Ferini-Strambi
Luigi
L
Sleep Disorders Center, Università Vita-Salute, IRCCS H San Raffaele, Italy. ferinistrambi.luigi@hsr.it
Manconi
Mauro
M
Castronovo
Vincenza
V
Riva
Laura
L
Bianchi
Anna
A
D018759:Adrenergic Uptake Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001341:Autonomic Nervous System / Q000187:drug effects* / Q000502:physiology; D002940:Circadian Rhythm; D019263:Dysthymic Disorder / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000294:innervation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000494:pharmacology* / Q000627:therapeutic use; D000077593:Reboxetine; D016037:Single-Blind Method; D012894:Sleep Stages / Q000187:drug effects*; D014851:Wakefulness / Q000187:drug effects
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D009025:Morpholines; D000077593:Reboxetine