Dj. Kupfer et al., PERSISTENT EFFECTS OF ANTIDEPRESSANTS - EEG SLEEP STUDIES IN DEPRESSED-PATIENTS DURING MAINTENANCE TREATMENT, Biological psychiatry, 35(10), 1994, pp. 781-793
Electroencephalographic (EEG) sleep studies represent a research tool
that can be used to examine depressed patients over different phases o
f their illness. We examined the long-term effects of imipramine on EE
G sleep in 27 Subjects who completed 3 years of maintenance treatment
on imipramine without experiencing a recurrence. The analyses were per
formed on EEG sleep data collected prior to acute treatment, after 3 m
onths in maintenance, and every 3 months thereafter. The major aim was
to examine specific changes in rapid eye movement (REM) and slow-wave
sleep (SWS) as they unfolded over the course of illness and recovery
during long-term drug maintenance. The acute changes in the sleep prof
ile produced by antidepressants remained essentially the same througho
ut the entire period of drug administration. The REM sleep parameters,
which were affected immediately, remained essentially unchanged there
after, even as long as 3 years into maintenance treatment. A rapid red
istribution of slow-wave sleep in the first part of the night was also
observed without an increase in the total amount of slow-wave sleep t
hroughout the night. The application of spectral analysis confirmed th
at the sleep changes following drug administration remained stable thr
oughout all phases of drug treatment. Thus, it appears that sustained
clinical improvement is accompanied by persistent sleep alterations on
tricyclic antidepressant medication.