EEG sleep measures in later-life bereavement depression - A randomized, double-blind, placebo-controlled evaluation of nortriptyline

The authors examined 1) effects of nortriptyline (NT) on electroencephalogr aphic (EEG) sleep measures in elderly patients with bereavement-related dep ression in remission under randomized, double-blind, placebo-controlled con ditions, and 2) the effects of clinical remission on sleep after discontinu ation of medication. Subjects were classified as responders to placebo (n=9 ) or NT (n=18) and had EEG sleep studies at three time-points: before treat ment (T-1), remitted on medication or placebo (T-2), and remitted off medic ation or placebo (T-3). As compared with placebo, NT was differentially ass ociated with decreases in REM sleep time and percent and increases in REM s leep density (T2). No changes in EEG sleep measures occurred in placebo res ponders. REM sleep measures in NT responders reverted to T-1 levels after T -3, with persistence of robust clinical remission and normal subjective sle ep quality. These data suggest that NT alters REM sleep, but that EEG sleep characteristics in bereavement-related depression persist into remission.