Using sleep to evaluate comparative serotonergic effects of paroxetine and citalopram.
BACKGROUND
SSRIs suppress rapid eye movement (REM) sleep, probably by increasing serotonin in the brainstem, and also increase sleep fragmentation. Although in the UK, paroxetine (PAR) and citalopram (CIT) have recommended doses of 20 mg/day for the treatment of depression, the recommended dose of CIT in USA is higher (40 mg). If similar doses of PAR and CIT have similar effects on central serotonin then they should have similar effects on sleep measures in volunteers.


METHODS
This was a randomised, double blind placebo controlled crossover study in 12 healthy volunteers. Subjects took PAR 20 mg mane, CIT 20 mg mane or placebo mane for 3 days and sleep was recorded overnight at home on the third night. Standard measures of sleep were derived.


RESULTS
REM sleep was significantly suppressed and sleep fragmentation increased by both drugs. Measures of REM sleep and sleep continuity previously found to be altered by SSRIs were considered together and compared with placebo as a 'serotonin response'; this was significantly greater in the PAR group.


CONCLUSIONS
Sleep effects typical of SSRIs were greater with PAR 20 mg/day than CIT 20 mg/day, suggesting greater effects on 5HT uptake blockade.
Wilson
S J
SJ
Psychopharmacology Unit, University of Bristol, University Walk, Bristol BS8 1TD, UK.
Bailey
J E
JE
Rich
A S
AS
Adrover
M
M
Potokar
J
J
Nutt
D J
DJ
D000328:Adult; D015283:Citalopram / Q000494:pharmacology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004341:Drug Evaluation; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D017374:Paroxetine / Q000494:pharmacology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D012890:Sleep / Q000187:drug effects* / Q000502:physiology; D012895:Sleep, REM / Q000187:drug effects*; D011795:Surveys and Questionnaires
D015283:Citalopram; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors