Differential effects of trimipramine and fluoxetine on sleep in geriatric depression

The effects of trimipramine, a tricyclic antidepressant (TCA) with atypical pharmacological properties, and fluoxetine, a selective serotonine reuptak e inhibitor (SSRI), were compared in an exploratory analysis using mood and polysomnographic parameters during a six-week double-blind trial in 19 dep ressed geriatric patients. In sleep EEG measures, trimipramine demonstrated clear-cut effects on sleep measures resulting in higher values for sleep e fficiency, total sleep time, stage 2 sleep, and shorter wake time, Under fl uoxetine treatment, the proportion of REM sleep was decreased and REM laten cy was lengthened, whereas no change in REM sleep parameters was observed i n the trimipramine group. The present data suggest that early antidepressan t effects of medication occur independently of drug-induced changes in obje ctive measures of sleep, i.e. suppression of REM sleep.