Insomnia improvement during antidepressant treatment and CLOCK gene polymorphism.
Sleep disturbances are commonly observed in mood disorders, and sleep manipulations can influence the clinical status. In the present study, we investigated the possible effect of the 3111 T/C circadian locomotor output cycles kaput (CLOCK) gene polymorphism on insomnia symptomatology during antidepressant treatment. One hundred seventy-eight inpatients were treated with fluvoxamine 300 mg/day (n = 147) or paroxetine 20-40 mg/day (n = 31), and either placebo or pindolol in a double blind design for 6 weeks. The severity of depressive symptoms was weekly assessed with the Hamilton Rating Scale for Depression (HAM-D). We observed a significantly higher presence of insomnia throughout the trial in homozygotes for the C variant (P = 0.026). Other demographic and clinical features were found not to be related with CLOCK polymorphisms. Overall, our findings may suggest that CLOCK genotype influences the time course of insomnia during antidepressant treatment. This, together with previous findings on this polymorphism could lead to a further dissection of the complexity of mood disorders.
Serretti
Alessandro
A
Department of Neuropsychiatric Sciences, Istituto Scientifico, Universitario Ospedale San Raffaele, University of Milan School of Medicine, Via Luigi Prinetti 29, 20127 Milan, Italy. serretti.alessandro@hsr.it
Cusin
Cristina
C
Benedetti
Francesco
F
Mandelli
Laura
L
Pirovano
Adele
A
Zanardi
Raffaella
R
Colombo
Cristina
C
Smeraldi
Enrico
E
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D056926:CLOCK Proteins; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D015999:Multivariate Analysis; D017374:Paroxetine / Q000627:therapeutic use; D010869:Pindolol / Q000627:therapeutic use; D011110:Polymorphism, Genetic; D012702:Serotonin Antagonists / Q000627:therapeutic use; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D015534:Trans-Activators / Q000235:genetics*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D012702:Serotonin Antagonists; D015534:Trans-Activators; D017374:Paroxetine; D010869:Pindolol; D056926:CLOCK Proteins; C538943:CLOCK protein, human; D016666:Fluvoxamine