Ott Geoffrey E, Rao Uma, Nuccio Innocencia, Lin Keh-Ming, Poland Russell E
Interdepartmental Training Program for Neuroscience, UCLA, Los Angeles, CA 90024, USA.
Psychopharmacology (Berl). 2002 Dec;165(1):29-36. doi: 10.1007/s00213-002-1165-4. Epub 2002 Nov 6.
The effects of antidepressant (AD) drugs on sleep in depressed patients and their relationship to AD response have been investigated previously. However, newer AD agents, which appear to have different effects on sleep, have not been evaluated systematically for their usefulness in predicting treatment response.
To examine the effect of bupropion sustained release (SR) (Wellbutrin SR) on sleep macroarchitecture, and to assess whether the observed electroencephalographic (EEG) sleep changes in response to a single dose of bupropion are associated with treatment response to the AD.
Twenty patients with unipolar major depressive disorder received EEG sleep assessments prior to treatment. Subjects were studied twice for 2 consecutive nights, with each 2-night session approximately 1 week apart. Baseline EEG sleep and the EEG sleep responses to placebo (baseline sleep) and a single dose of bupropion SR (150 mg, PO) were measured using a randomized, double-blind, crossover design. The participants then received open-label treatment with bupropion SR for about 8 weeks.
No relationship was observed between baseline EEG sleep measures and response to treatment with bupropion. However, a statistically significant relationship was found between latency to the onset of rapid eye movement (REM) sleep following a single dose of bupropion and clinical response to treatment with bupropion. Responders showed an increase in REM latency following bupropion challenge, whereas non-responders showed a decrease. Moreover, the REM latency change in response to bupropion challenge correlated with change in depression ratings as a result of treatment.
These findings suggest that bupropion's effect on REM latency and its AD action might be linked, possibly via dopamine (D(2)) receptor-mediated effects, or by noradrenergic mechanism(s).
先前已对抗抑郁药（AD）对抑郁症患者睡眠的影响及其与AD反应的关系进行了研究。然而，似乎对睡眠有不同影响的新型AD药物尚未针对其预测治疗反应的效用进行系统评估。
研究安非他酮缓释片（Wellbutrin SR）对睡眠宏观结构的影响，并评估单次服用安非他酮后观察到的脑电图（EEG）睡眠变化是否与AD治疗反应相关。
20名单相重度抑郁症患者在治疗前接受了EEG睡眠评估。受试者连续两晚进行两次研究，每次两晚的研究间隔约1周。采用随机、双盲、交叉设计测量基线EEG睡眠以及对安慰剂（基线睡眠）和单次服用安非他酮缓释片（150 mg，口服）的EEG睡眠反应。参与者随后接受了约8周的安非他酮缓释片开放标签治疗。
未观察到基线EEG睡眠指标与安非他酮治疗反应之间的关系。然而，发现单次服用安非他酮后快速眼动（REM）睡眠开始潜伏期与安非他酮治疗的临床反应之间存在统计学上的显著关系。有反应者在安非他酮激发后REM潜伏期增加，而无反应者则减少。此外，安非他酮激发引起的REM潜伏期变化与治疗后抑郁评分的变化相关。
这些发现表明，安非他酮对REM潜伏期的影响及其AD作用可能相关，可能通过多巴胺（D（2））受体介导的作用，或通过去甲肾上腺素能机制。
