Hajak G, Rodenbeck A, Adler L, Huether G, Bandelow B, Herrendorf G, Staedt J, Rüther E
Department of Psychiatry, University of Goettingen, Germany.
Pharmacopsychiatry. 1996 Sep;29(5):187-92. doi: 10.1055/s-2007-979569.
Nocturnal melatonin secretion and polysomnographic sleep patterns were investigated in ten patients with chronic primary insomnia (age 41.3 +/- 9.5 years) and in five healthy subject, (age 27.2 +/- 0.7 years) after either a single intravenous administration of 25 mg doxepin or placebo in a randomized, double blind, and cross-over setting. In the patient group a third session was performed after a three-week open oral treatment with 25 mg doxepin daily. The single-dose administration of doxepin did not affect plasma melatonin concentrations in either the patients on the healthy subjects. After three weeks of oral doxepin intake by the patients, the area under the curve of total nocturnal plasma melatonin concentration was significantly increased by 26% and the peak values were increased by 30%. Both after the single i.v. treatment as well as after long-term oral administration, doxepin also significantly improved sleep latency, total sleep time, and sleep efficiency in the insomniacs as well as the healthy subjects, whereas the nocturnal wake time was decreased. These findings indicate that this tricyclic antidepressant not only improves sleep and but also preserves the secretion of a hormone which is believed to play a special role in the circadian sleep-wake rhythm. Long-term doxepin treatment of chronic insomniac patients not only improves sleep but also restores nocturnal melatonin secretion in these patients.
在一项随机、双盲、交叉试验中，对10名慢性原发性失眠患者（年龄41.3±9.5岁）和5名健康受试者（年龄27.2±0.7岁）分别单次静脉注射25毫克多塞平或安慰剂后，研究了夜间褪黑素分泌和多导睡眠图睡眠模式。在患者组中，在进行为期三周的每日口服25毫克多塞平的开放治疗后，进行了第三次试验。多塞平的单剂量给药对患者或健康受试者的血浆褪黑素浓度均无影响。患者口服多塞平三周后，夜间血浆褪黑素总浓度曲线下面积显著增加26%，峰值增加30%。在单次静脉注射治疗以及长期口服给药后，多塞平还显著改善了失眠患者和健康受试者的睡眠潜伏期、总睡眠时间和睡眠效率，而夜间觉醒时间减少。这些发现表明，这种三环类抗抑郁药不仅改善睡眠，而且还能维持一种被认为在昼夜睡眠-觉醒节律中起特殊作用的激素的分泌。对慢性失眠患者进行长期多塞平治疗不仅能改善睡眠，还能恢复这些患者的夜间褪黑素分泌。
