Szuba M P, Baxter L R, Altshuler L L, Allen E M, Guze B H, Schwartz J M, Liston E H
Department of Psychiatry, University of Pennsylvania, School of Medicine, Philadelphia 19104-4283.
Psychiatry Res. 1994 Mar;51(3):283-95. doi: 10.1016/0165-1781(94)90015-9.
Early morning sleep deprivation (patient awake from 0200 to 2200 hours) produces a same-day antidepressant effect in approximately one-half of patients with major depression. Unfortunately, these antidepressant effects are short-lived and patients usually relapse to baseline depression levels within 48 hours. Recent work suggests, however, that the use of lithium with early morning sleep deprivation sustains this rapid antidepressant effect and makes it clinically useful. In a 30-day study, we compared the abilities of four different treatments (lithium plus early morning sleep deprivation, lithium plus a control sleep deprivation procedure, and desipramine with either of the two sleep manipulations) to induce a rapid (next-day) and sustained antidepressant response in 16 depressed patients. Lithium plus early morning sleep deprivation produced a quicker response than lithium with the control sleep deprivation, and the response was sustained for at least 30 days. In this design, however, lithium/early morning sleep deprivation was no faster than either of the two desipramine/sleep deprivation conditions in inducing remission. These results support the results of previous studies and suggest further investigation of this novel sleep/pharmacologic intervention is warranted.
清晨睡眠剥夺（患者从凌晨2点到晚上10点保持清醒）对大约一半的重度抑郁症患者会产生当日抗抑郁效果。不幸的是，这些抗抑郁效果是短暂的，患者通常会在48小时内恢复到基线抑郁水平。然而，最近的研究表明，在清晨睡眠剥夺的同时使用锂盐可以维持这种快速抗抑郁效果，并使其具有临床实用性。在一项为期30天的研究中，我们比较了四种不同治疗方法（锂盐加清晨睡眠剥夺、锂盐加对照睡眠剥夺程序、地昔帕明与两种睡眠干预方法中的任意一种联用）在16名抑郁症患者中诱导快速（次日）和持续抗抑郁反应的能力。锂盐加清晨睡眠剥夺比锂盐加对照睡眠剥夺产生的反应更快，且该反应持续了至少30天。然而，在这种设计中，锂盐/清晨睡眠剥夺在诱导缓解方面并不比两种地昔帕明/睡眠剥夺情况中的任何一种更快。这些结果支持了先前研究的结果，并表明有必要对这种新型睡眠/药物干预进行进一步研究。
