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Maintenance nortriptyline effects on electroencephalographic sleep in elderly patients with recurrent major depression: Double-blind, placebo- and plasma-level-controlled evaluation
Abstract
Our aim was to contrast the effects of maintenance nortriptyline and placebo on electroencephalographic sleep measures in elderly recurrent depressives who survived 1-year without recurrence of depression. Patients on nortriptyline took longer to fall asleep and did not maintain sleep better than patients on placebo; however, maintenance nortriptyline was associated with more delta-wave production and higher delta-wave density in the first non-REM (NREM) period relative to the second. Nortriptyline levels were positively but weakly related to all-night delta-wave production during maintenance (accounting for 6.6% of the variance in delta-wave counts). Total phasic REM activity increased 100% under chronic nortriptyline relative to placebo, with a robust increase in the rate of REM activity generation across the night. Effective long-term pharmacotherapy of recurrent major depression is associated with enhancement in the rate of delta-wave production in the first NREM period (i.e., delta sleep ratio) and of REM activity throughout the night.
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“Additionally, a study of maintenance nortriptyline therapy in elderly depressed patients showed that they took longer to fall asleep than patients on placebo [Reynolds et al., 1997].”
From Depression, sleep physiology, and antidepressant drugs (2001) · cites this paper as Reynolds et al., 1997
In the citing paper
“Placebo and plasma concentration-controlled research of nortriptyline maintenance therapy in elderly depressed patients with no recurrence in 1 year revealed persistent REM suppression and increased REM latency [Reynolds et al., 1997;Taylor et al., 1999].”
From Depression, sleep physiology, and antidepressant drugs (2001) · cites this paper as Reynolds et al., 1997
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Cited by
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Kushida, C. A., Littner, M. R., Morgenthaler, T., Alessi, C. A., Bailey, D., Coleman, J., Friedman, L., Hirshkowitz, M., Kapen, S., Kramer, M., et al. (2005) · Sleep · doi:10.1093/sleep/28.4.499 · Cited by 2,054
Sleep and depression--results from psychobiological studies: an overview
Riemann, D., Berger, M., & Voderholzer, U. (2001) · Biological Psychology · doi:10.1016/s0301-0511(01)00090-4 · Cited by 653
Antidepressants and their effect on sleep
Mayers, A. G., & Baldwin, D. S. (2005) · Human Psychopharmacology: Clinical and Experimental · doi:10.1002/hup.726 · Cited by 323
Depression, sleep physiology, and antidepressant drugs
Winokur, A., Gary, K. A., Rodner, S., Rae-Red, C., Fernando, A. T., & Szuba, M. P. (2001) · Depression and Anxiety · doi:10.1002/da.1043 · Cited by 179
Metadata
- Authors
- Reynolds, C. F., Buysse, D. J., Brunner, D. P., Begley, A. E., Dew, M. A., Hoch, C. C., Hall, M., Houck, P. R., Mazumdar, S., Perel, J. M., & Kupfer, D. J.
- Affiliations
- University of Pittsburgh Medical Center (US)
- Corresponding author
- Reynolds, Charles F.
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 1997-10
- Volume
- 42
- Issue
- 7
- Pages
- 560-567
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2093261019
- Cited by
- 31
- References
- 0
- Citations by year
- 2023: 1 · 2018: 2 · 2016: 5 · 2015: 1 · 2014: 1 · 2013: 1
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (P30MH052247, MH-43832, R01MH037869)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- nortriptyline, recurrent major depressive disorder, elderly patients, sleep latency, plasma drug concentration, tricyclic antidepressants
- MeSH terms
- Aged, Antidepressive Agents, Tricyclic, Depressive Disorder, Double-Blind Method, Electroencephalography, Humans, Nortriptyline, Psychiatric Status Rating Scales, Sleep, Sleep, REM
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