title: Accelerating symptom-reduction in late-life depression: a double-blind, randomized, placebo-controlled trial of sleep deprivation.
abstract: OBJECTIVE
  Authors tested the hypothesis that one night of total sleep deprivation (TSD) would accelerate antidepressant response to paroxetine, as compared with TSD+placebo (PBO) and paroxetine-alone, in late-life major depression.
  
  
  METHODS
  Eighty elderly outpatients with current episodes of non-psychotic, non-bipolar major depression were randomly assigned to one of three treatment conditions: TSD+paroxetine (N = 27), TSD + PBO (N = 27), and paroxetine-only (N = 26). Primary outcome was percentage of subjects in each condition who demonstrated early response (Hamilton Rating Scale for Depression scores [Ham-D: 17-item] of < or = 10) or remission (score of < or = 7) on Day 14.
  
  
  RESULTS
  Response rates after 14 days were 22% in subjects randomly assigned to the TSD + paroxetine condition, 41% in TSD + PBO, and 46% in paroxetine alone. Remission rates after 14 days were 11% in TSD+paroxetine, 22% in TSD + PBO, and 38% in paroxetine. After adjusting for baseline depression severity, there were no statistically significant differences in response or remission rates.
  
  
  CONCLUSIONS
  Contrary to the study hypothesis, one night of total sleep deprivation did not accelerate onset of antidepressant response to paroxetine pharmacotherapy of late-life depression. The data suggest, rather, that the two interventions might have counteracted each other.
authors.affiliation: Intervention Research Center for Late-Life Mood Disorders (IRC/LLMD), Univ. of Pittsburgh School of Medicine, 3811 O'Hara Street, E-113521, Pittsburgh, PA 15213, USA. Reynoldscf@upmc.edu
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
authors.forename: Gwenn S
authors.initials: GS
authors.lastname: Smith
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.forename: Benoit H
authors.initials: BH
authors.lastname: Mulsant
authors.forename: Mark D
authors.initials: MD
authors.lastname: Miller
authors.forename: Maryann
authors.initials: M
authors.lastname: Schlernitzauer
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Stack
authors.forename: Patricia R
authors.initials: PR
authors.lastname: Houck
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Pollock
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004357:Drug Synergism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000627:therapeutic use*; D010555:Personality Inventory; D012892:Sleep Deprivation / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D017374:Paroxetine