Sleep Architecture in Depressed Patients Treated with Desvenlafaxine
Objective: The primary objective of this study is to investigate the effects of desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor, on sleep architecture in depressed patients, with a focus on changes in slow wave sleep (SWS), rapid eye movement (REM) sleep, and sleep efficiency. Secondarily, subjective changes in sleep quality and illness severity are assessed. Methods: This was a prospective, double-blind, randomized, placebo-controlled study. Patients with major depressive disorder were randomized to receive a placebo or 50mg once daily of desvenlafaxine. Sleep architecture, subjective sleep quality, and illness severity were measured at baseline, after 3-5 days of treatment, and after 28-31 days of treatment. Sleep architecture was assessed using overnight, ambulatory polysomnography. Subjective sleep quality was evaluated using the self-reported Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and a visual analogue scale (VAS). Illness severity was measured using the Hamilton Depression Rating Scale (HDRS), Montgomery Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HARS), and the Clinical Global Impression-Severity (CGI-S) scale. Results: Nine patients (two males and seven females), aged 19 to 48 years old, participated. There were no significant differences between the placebo and desvenlafaxine-treated groups on any sociodemographic measures. At baseline, there were no significant differences in sleep architecture or clinical measures between the two groups. At day 3-5, latency to REM sleep was significantly increased for the desvenlafaxine-treated group compared to placebo, and although this measure was still increased at day 28-31, the difference was no longer significant. No differences were found between the two groups at day 3-5 or day 28-31 on measures of sleep continuity or time spent in each sleep stage. Treatment with desvenlafaxine significantly decreased scores on the PSQI, HDRS, MADRS, HARS, and the CGI-S. Conclusion: Treatment of depressed patients with desvenlafaxine decreased illness severity and improved subjective sleep quality. Minimal changes to sleep architecture were observed, with an acute increase in REM sleep latency being the only significant effect. These results suggest that desvenlafaxine may be capable of improving sleep quality in depressed patients, though further research with a larger sample size is needed to confirm and expand on these findings.
URI for this recordhttp://hdl.handle.net/1974/15693
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