Therapeutic sleep deprivation and antidepressant medication in patients with major depression.

Although there is a body of literature on the therapeutic efficacy of sleep deprivation (SD) there are only a few investigations in which the relevance of antidepressive medication for the clinical efficacy of SD has been studied. Based on the literature and on our own investigations with major depressed patients it seems that for the day-1 response it does not matter if and what type of antidepressive medication the patient receives. Furthermore, the results of our double blind study reveal that the day-1 response to total sleep deprivation (TSD) is not associated with a clear relationship to the outcome after 4 weeks treatment with either fluvoxamine or maprotiline. On the other hand, our data indicate that the day-2 response to TSD is significantly correlated with a beneficial outcome after subchronic treatment with maprotiline.