Effects of long-term administration of nicotine and fluoxetine on sleep in depressed patients.
BACKGROUND
The long-term effects of transdermal nicotine and fluoxetine on sleep and major depression were investigated.


METHODS
Two independent groups of 12 nonsmoking patients with major depression (Hamilton Rating >/=18) served as subjects. The first group received transdermal nicotine (17.5 mg) while the second group received an oral dose of 20 mg/day of fluoxetine, 5 days weekly for 6 months, 3 days weekly at month 7 and 1 day/week at month 8. From the 9(th) to the 14(th) month, once a week a patch without nicotine and an oral placebo substituted nicotine and fluoxetine. Polysomnographic recordings were conducted and depressive symptoms evaluated at baseline and on a monthly basis during medication and during withdrawal.


RESULTS
Nicotine diminished wakefulness and stage 1 and increased REM sleep latency and slow wave sleep throughout the study. A small decrease of REM sleep duration was observed upon nicotine withdrawal. Fluoxetine increased wakefulness, stage 1 duration and REM latency and decreased the sleep efficiency index. Both nicotine and fluoxetine improved mood according to HRS-D scores.


CONCLUSIONS
Nicotine and fluoxetine showed equivalent antidepressant efficacy; however, important differences in sleep parameters were observed between nicotine and fluoxetine, both during their administration and following withdrawal.
Haro
Reyes
R
Clínica de Trastornos de Sueño, Facultad de Medicina, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Mexico City.
Drucker-Colín
René
R
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004569:Electroencephalography; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009538:Nicotine / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D010919:Placebos; D017286:Polysomnography; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D012890:Sleep / Q000187:drug effects*; D014851:Wakefulness / Q000187:drug effects
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine; D009538:Nicotine; D018722:Nicotinic Agonists; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors