Scharf M B, Sachais B A
Center for Research in Sleep Disorders, Cincinnati, Ohio 45246.
J Clin Psychiatry. 1990 Sep;51 Suppl:13-7.
Trazodone (150 mg to 400 mg) was administered to six depressed patients with significant sleep disturbances in an 8-week single-blind study design. Patients were evaluated psychologically by means of the Hamilton Rating Scales for Anxiety and Depression. Polysomnographic monitoring in the sleep laboratory was conducted at each of the time points corresponding to the psychiatric evaluations. Five of the six subjects completed treatment. Patients showed a significant improvement in symptoms of depression and in their polysomnographic-determined sleep architecture. There was a 44% improvement in persistent sleep latency, decreasing from a mean +/- SD of 51.0 +/- 59.3 minutes at baseline to 28.5 +/- 24.2 minutes after 5 weeks of active treatment. Total sleep time improved 14% from 387.1 +/- 59.2 minutes at baseline to 441.3 +/- 23.7 minutes after 5 weeks. Stage IV sleep more than doubled with an increase of 153% from 1.9 +/- 3.0% at baseline to a more normal 4.8 +/- 5.5%. There was no change in percentage of rapid eye movement (REM); however, REM latency increased 28% from a mean of 74.6 +/- 35.9 minutes at baseline to a mean of 95.6 +/- 28.8 minutes. Sleep efficiency improved from 80.6 +/- 12.3%, considered clinically significant insomnia, to 91.9 +/- 4.9%, which is well within normal sleep patterns.
在一项为期8周的单盲研究设计中，对6名患有严重睡眠障碍的抑郁症患者服用曲唑酮（150毫克至400毫克）。通过汉密尔顿焦虑和抑郁评定量表对患者进行心理评估。在与精神科评估相对应的每个时间点，在睡眠实验室进行多导睡眠图监测。6名受试者中有5名完成了治疗。患者的抑郁症状和多导睡眠图确定的睡眠结构有显著改善。持续性睡眠潜伏期改善了44%，从基线时平均±标准差51.0±59.3分钟降至积极治疗5周后的28.5±24.2分钟。总睡眠时间从基线时的387.1±59.2分钟增加了14%，至5周后的441.3±23.7分钟。IV期睡眠增加了153%，从基线时的1.9±3.0%增加到更正常的4.8±5.5%，增加了一倍多。快速眼动（REM）百分比没有变化；然而，REM潜伏期从基线时的平均74.6±35.9分钟增加了28%，至平均95.6±28.8分钟。睡眠效率从被认为具有临床意义的失眠的80.6±12.3%提高到91.9±4.9%，这完全在正常睡眠模式范围内。
