Sleep and daytime sleepiness the next day following single night-time doseof fluvoxamine, dothiepin and placebo in normal volunteers

To explore the effects of sedating and non-sedating antidepressants, we con ducted a placebo-controlled, double-blind cross-over study in 12 normal sub jects of the effects of a single night-time dose of fluvoxamine 100 mg, dot hiepin 100 mg or placebo on night-time sleep recorded at home, and sleepine ss and performance the following day. Night-time sleep was altered signific antly by both drugs, with main effects on rapid eye movement (REM) sleep an d sleep continuity. Dothiepin increased total sleep time, REM latency and s tage 2 sleep and decreased arousals, wake after sleep onset and stage 1, wh ereas fluvoxamine decreased total sleep time and REM time and increased wak e after sleep onset. Sleep latencies in daytime naps were significantly sho rter for dothiepin and longer for fluvoxamine, showing that subjects were m ore sleepy when taking dothiepin. Electroencephalograms (EEG) performed dur ing performance tasks failed to distinguish significantly between drugs. Th ere were no significant differences between groups on our measures of track ing performance or reaction time; however, these tasks were designed primar ily to provide a standard setting in which to monitor continuous EEG, and w ere unsuitable to detect sleepiness effects themselves. Saccadic eye moveme nt velocity, acceleration and deceleration showed small nonsignificant chan ges after both drugs. Mood self ratings showed no significant differences a mong the groups. Subjective measures of night-time sleep reflected the obje ctive measures of sleep continuity, and the items for difficulty and speed of wakening in the morning were significantly higher (i,e. more difficulty and slower) in the dothiepin group. The home-recorded sleep findings after fluvoxamine in this study were very similar to sleep laboratory studies wit h other antidepressant drugs, thus providing more validation of the home re cording method.