HYPNOTICS AS CONCURRENT MEDICATION IN DEPRESSION - A PLACEBO-CONTROLLED, DOUBLE-BLIND COMPARISON OF FLUNITRAZEPAM AND LORMETAZEPAM IN PATIENTS WITH MAJOR DEPRESSION, TREATED WITH A (TRI)CYCLIC ANTIDEPRESSANT

The addition of benzodiazepine hypnotics to a treatment with tricyclic antidepressants has received little systematic study. In a double-bli nd placebo-controlled design, the effects on mood and on sleep of two benzodiazepine hypnotics (lormetazepam and flunitrazepam) were studied in patients with major depression who were also treated with maprotil ine or nortriptyline. After 4 weeks of combined treatment, lormetazepa m resulted in a significantly greater decrease in the score on the Ham ilton Depression Subscale than placebo, while there was a non-signific ant trend in favour of lormetazepam in comparison with flunitrazepam. With respect to sleep EEGs, lormetazepam resulted in a significantly g reater suppression of REM sleep. The differences between lormetazepam and flunitrazepam may be partly explained by the shorter half-live of lormetazepam.