Effects of fluoxetine on the polysomnogram in outpatients with major depression

This study investigated the effects of open-label fluoxetine (20 mg/d) on t he polysomnogram (PSG) in depressed outpatients (n = 58) who were treated f or 5 weeks, after which dose escalation was available (less than or equal t o 40 mg/d), based on clinical judgment. Thirty-six patients completed all 1 0 weeks of acute phase treatment and responded (HRS-D less than or equal to 10). PSG assessments were conducted and subjective sleep evaluations were gathered at baseline and at weeks 1, 5, and 10. Of the 36 subjects who comp leted the acute phase, 17 were reevaluated after 30 weeks on continuation p hase treatment and 13 after approximately 7 weeks (range 6-8 weeks) followi ng medication discontinuation. Acute phase treatment in responders was asso ciated with significant increases in REM I latency, Stage 1 sleep, and REM density, as well as significant decreases in sleep efficiency, total REM sl eep, and Stage 2 sleep. Conversely, subjective measures of sleep indicated a steady improvement during acute phase treatment. After fluoxetine was dis continued, total REM sleep and sleep efficiency were found to be increased as compared to baseline. (C) 1999 American College of Neuropsychopharmacolo gy. Published by Elsevier Science Inc.