Modafinil reduces microsleep during partial sleep deprivation in depressed patients

被引:13
作者
Beck, J. [1 ,2 ]
Hemmeter, U. [3 ]
Brand, S. [1 ,2 ]
Muheim, F. [1 ,2 ]
Hatzinger, M. [4 ]
Holsboer-Trachsler, E. [1 ,2 ]
机构
[1] Univ Basel, Hosp Psychiat, Ctr Affect Disorders & Depress, Basel, Switzerland
[2] Ctr Sleep Med, Basel, Switzerland
[3] Psychiat Serv Ctr St Gallen, Wil Ch, Switzerland
[4] Univ Basel CH, Psychiat Out Patient Dept, Basel, Switzerland
基金
瑞士国家科学基金会;
关键词
Modafinil; Sleep deprivation; Partial sleep deprivation; Depressive disorders; SEROTONIN LEVELS; PHASE ADVANCE; D-AMPHETAMINE; BRIGHT LIGHT; ANTIDEPRESSANT; PLACEBO; AUGMENTATION; WAKEFULNESS; FLUMAZENIL; RECURRENCE;
D O I
10.1016/j.jpsychires.2010.01.008
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: Sleep deprivation (SD) can induce a prompt decrease in depressive symptoms within 24 h. Following the recovery night, however, a relapse into depression occurs in most patients. Recovery sleep, naps and even very short episodes of sleep (microsleep; MS) during SD have been shown to provoke a rapid relapse into depression. This study tested the hypothesis that modafinil reduces MS during SD and stabilizes the treatment response to PSD compared to placebo. Methods: A total of 28 patients (13 men, 15 women; age 45.1 +/- 12.1 years) with a major depressive episode and a cumulative daytime microsleep of five or more minutes were investigated using a doubleblind placebo-controlled study design. All patients were treated with a stable mirtazapine monotherapy. A partial SD (PSD) was performed after one week. Additional morning treatment with modafinil vs. placebo started during PSD and was maintained over two weeks. Sleep-EEG and MS episodes were recorded with a portable EEG. Depression severity was assessed using the Hamilton Depression Rating Scale before, during and after PSD and at follow-ups after one and two weeks. Results: Patients treated with modafinil showed significantly reduced microsleep during PSD (11.63 +/- 15.99 min) compared to the placebo group (47.77 +/- 65.31 min). This suppression of MS was not associated with the antidepressive effect of PSD. Conclusions: Compared to placebo, modafinil was efficient in reducing daytime microsleep following partial sleep deprivation but did not enhance the antidepressive effects of PSD and did not stabilize antidepressive effects over two weeks. C) 2010 Elsevier Ltd. All rights reserved.
引用
收藏
页码:853 / 864
页数:12
相关论文
共 58 条
[1]   QUANTITATIVE RATING OF DEPRESSIVE STATES [J].
BECH, P ;
GRAM, LF ;
DEIN, E ;
JACOBSEN, O ;
VITGER, J ;
BOLWIG, TG .
ACTA PSYCHIATRICA SCANDINAVICA, 1975, 51 (03) :161-170
[2]   Ongoing lithium treatment prevents relapse after total sleep deprivation [J].
Benedetti, F ;
Colombo, C ;
Barbini, B ;
Campori, E ;
Smeraldi, E .
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 1999, 19 (03) :240-245
[3]   Pharmacogenetics of Modafinil After Sleep Loss: Catechol-O-Methyltransferase Genotype Modulates Waking Functions But Not Recovery Sleep [J].
Bodenmann, S. ;
Xu, S. ;
Luhmann, U. F. O. ;
Arand, M. ;
Berger, W. ;
Jung, H. H. ;
Landolt, H. P. .
CLINICAL PHARMACOLOGY & THERAPEUTICS, 2009, 85 (03) :296-304
[4]  
Borbely A A, 1982, Hum Neurobiol, V1, P195
[5]   Modafinil, d-amphetamine and placebo during 64 hours of sustained mental work .2. Effects on two nights of recovery sleep [J].
Buguet, A ;
Montmayeur, A ;
Pigeau, R ;
Naitoh, P .
JOURNAL OF SLEEP RESEARCH, 1995, 4 (04) :229-241
[6]   The effects of body posture on resting electroencephalographic activity in sleep-deprived subjects [J].
Caldwell, JA ;
Prazinko, BF ;
Hall, KK .
CLINICAL NEUROPHYSIOLOGY, 2000, 111 (03) :464-470
[7]   Distinctive effects of modafinil and d-amphetamine on the homeostatic and circadian modulation of the human waking EEG [J].
Chapotot, F ;
Pigeau, R ;
Canini, F ;
Bourdon, L ;
Buguet, A .
PSYCHOPHARMACOLOGY, 2003, 166 (02) :127-138
[8]   Narcolepsy in orexin knockout mice:: Molecular genetics of sleep regulation [J].
Chemelli, RM ;
Willie, JT ;
Sinton, CM ;
Elmquist, JK ;
Scammell, T ;
Lee, C ;
Richardson, JA ;
Williams, SC ;
Xiong, YM ;
Kisanuki, Y ;
Fitch, TE ;
Nakazato, M ;
Hammer, RE ;
Saper, CB ;
Yanagisawa, M .
CELL, 1999, 98 (04) :437-451
[9]  
Cohen J., 1988, Statistical power analysis for the behavioral sciences, VSecond
[10]   Early symptomatic worsening during treatment with fluoxetine in major depressive disorder: Prevalence and implications [J].
Cusin, Cristina ;
Fava, Maurizio ;
Amsterdam, Jay D. ;
Quitkin, Frederic M. ;
Reimherr, Frederick W. ;
Beasley, Charles M., Jr. ;
Rosenbaum, Jerrold E. ;
Perlis, Roy H. .
JOURNAL OF CLINICAL PSYCHIATRY, 2007, 68 (01) :52-57