Nefazodone and REM sleep: how do antidepressant drugs decrease REM sleep?
Abstract
In previous uncontrolled studies, nefazodone, a new antidepressant drug, increased REM sleep or had no effect on REM sleep. We report a double-blind, placebo-controlled, parallel group study on effects of nefazodone (N) on polysomnographic sleep variables in healthy human volunteers. Nefazodone was administered for 16 consecutive days, and nocturnal sleep, as well as multiple sleep latency test (MSLT), was monitored before, during, and after N administration. We found that N had no effect on any measured REM sleep variable including REM sleep duration, REM density, and nocturnal REM sleep distribution. Nefazodone also had no significant effect on nocturnal total sleep time or NREM variables, but increased daytime alertness measured by the MSLT. Since N is a potent serotonin reuptake blocker, the present findings that N had no effect on REM sleep cast doubt on the hypothesis that antidepressant drugs decrease REM sleep by increasing serotonergic neurotransmission. A review of other relevant work also casts doubt on this hypothesis.
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Nefazodone (200-400mg) reduced total sleep time, and increased nocturnal awakenings, when compared to placebo, in 120 healthy volunteers.
“In contrast to some findings in depressed groups, (Vogel et al., 1998) showed that nefazodone (200400mg) reduced total sleep time, and increased nocturnal awakenings, when compared to placebo, in 120 healthy volunteers.”
From Antidepressants and their effect on sleep (2005) · cites this paper as Vogel et al., 1998
In healthy volunteers, nefazodone 200-400mg left REM time, REM latency, REM density, and REM% unchanged relative to baseline and placebo.
“REM time, REML, REMD & REM% all remained unchanged, relative to baseline and PLC”
From Antidepressants and their effect on sleep (2005) · cites this paper as Vogel, 1998
In healthy volunteers, total sleep time was significantly less with nefazodone 200-400mg than placebo on day 1 (p<.05), normalised by day 2.
“TST sig less NEF than PLC day 1 (P<.05), normalised by day 2”
From Antidepressants and their effect on sleep (2005) · cites this paper as Vogel, 1998
In healthy volunteers, wake after sleep onset was significantly more with nefazodone 200-400mg than placebo on day 1 (p<.05).
“WMINS sig more with NEF than PLC day 1 (p<.05)”
From Antidepressants and their effect on sleep (2005) · cites this paper as Vogel, 1998
Cited by
Sorted by citations
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 · see citing works
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 · see citing works
- Authors
- Vogel, G., Cohen, J., Mullis, D., Kensler, T., & Kaplita, S.
- Corresponding author
- Vogel, Gerald
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-01
- Volume
- 21
- Issue
- 1
- Pages
- 70-77
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W2408487941
- Cited by
- 44
- References
- 0
- Citations by year
- 2025: 1 · 2016: 2 · 2014: 1
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- nefazodone, REM sleep, antidepressants, REM sleep suppression, serotonin reuptake inhibition, serotonergic neurotransmission, multiple sleep latency test, daytime alertness, polysomnography, REM density, REM sleep duration
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Piperazines, Serotonin, Sleep Stages, Sleep, REM, Triazoles, Antidepressive Agents, Second-Generation
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