title: Melatonin treatment of winter depression following total sleep deprivation: waking EEG and mood correlates.
abstract: Patients with winter depression (seasonal affective disorder (SAD)) commonly complain of sleepiness. Sleepiness can be objectively measured by spectral analysis of the waking electroencephalogram (EEG) in the 1-10 Hz band. The waking EEG was measured every 3 h in 16 female SAD patients and 13 age-matched control women throughout a total sleep deprivation of 30 h. Melatonin (or placebo) under double-blind conditions was administered subsequently (0.5 mg at 1700 h for 6 days), appropriately timed to phase advance circadian rhythms, followed by reassessment in the laboratory for 12 h. The increase in EEG power density in a narrow theta band (5-5.99 Hz, derivation Fz-Cz) during the 30 h protocol was significantly attenuated in patients compared with controls (difference between linear trends p=0.037). Sleepiness (p=0.092) and energy (p=0.045) self-ratings followed a similar pattern. Six patients improved after sleep deprivation (> or =50% reduction on SIGH-SAD(22) score). EEG power density dynamics was correlated with clinical response to sleep deprivation: the steeper the build-up (as in controls), the better the improvement (p<0.05). There was no differential effect of melatonin or placebo on any measure; both treatments stabilized the improvement. Overall, patients with winter depression manifest similar wake EEG characteristics as long sleepers or late chronotype with respect to an insufficient build-up of homeostatic sleep pressure. Sleep deprivation was an effective antidepressant treatment for some patients, but evening melatonin was not more efficacious than placebo in sustaining this antidepressant effect.
authors.affiliation: Institute of Internal Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia. dani@irs.ru
authors.forename: Konstantin V
authors.initials: KV
authors.lastname: Danilenko
authors.forename: Arcady A
authors.initials: AA
authors.lastname: Putilov
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects* / Q000502:physiology; D016022:Case-Control Studies; D006970:Disorders of Excessive Somnolence / Q000188:drug therapy / Q000209:etiology; D004311:Double-Blind Method; D004569:Electroencephalography / Q000187:drug effects*; D005260:Female; D006801:Humans; D016014:Linear Models; D008550:Melatonin / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D016574:Seasonal Affective Disorder / Q000150:complications / Q000188:drug therapy*; D012892:Sleep Deprivation / Q000150:complications*; D013057:Spectrum Analysis / Q000379:methods; D014851:Wakefulness / Q000502:physiology
chemical_list: D008550:Melatonin