SLEEP CLUSTER AROUSAL ANALYSIS AND TREATMENT RESPONSE TO HETEROCYCLICANTIDEPRESSANTS IN PATIENTS WITH MAJOR DEPRESSION

Background: A close link between sleep normalisation and antidepressan t response in depressed patients has been reported. We attempt to sepa rate early antidepressant treatment responders from nonresponders by t he use of sleep EEG recordings. Methods: Sleep EEG recordings were per formed in 20 inpatients with a unipolar major depressive disorder duri ng the first and third week of treatment with heterocyclic antidepress ants. Acute treatment polygraphic measures with microarousal analysis were used to predict response. Response was defined as a minimum reduc tion of greater than or equal to 30% in the v. Zerssen Depression Scal e after 3 weeks. Results: Compared to the 11 nonresponders, the 9 resp onders initially showed a highly significant increase of arousals duri ng sleep quantified with the cluster disturbed sleep (CDS), whereas th e classical sleep parameters (REM, stage I-IV) had no predictive value . Conclusions: The validity of our results is limited by the small num ber of patients and the lacking randomised assignment. Nevertheless th e results are still interesting. Because the CDS clearly separated res ponders from nonresponders at treatment onset. This could be due to a different reagibility of the catecholaminergic system. The data indica te that the CDS can be helpful for the prediction of early antidepress ant treatment response. (C) 1998 Elsevier Science B.V.