Hinze-Selch D, Mullington J, Orth A, Lauer C J, Pollmächer T
Max Planck Institute of Psychiatry, Clinical Institute, Munich, Germany.
Biol Psychiatry. 1997 Aug 15;42(4):260-6. doi: 10.1016/S0006-3223(96)00347-2.
Polysomnographic studies on the effects of clozapine, an atypical antipsychotic agent with strong sedative properties, on night sleep report inconsistent results. Most of these studies did not include baseline recordings and were not controlled for clozapine-induced fever, which is known to alter nocturnal sleep. We conducted a 2-week longitudinal polysomnographic investigation in 10 long-term drug-free schizophrenic patients prior to and at the end of the first and second weeks of clozapine treatment. Rectal temperature was measured daily and patients with fever (> 37.9 degrees C) were excluded. Clozapine significantly improved sleep continuity. In addition, non-rapid eye movement (NREM) sleep and in particular stage 2 sleep increased significantly, while the amounts of stage 4 and slow-wave sleep decreased significantly. Clozapine increased significantly REM density, but it did not affect the amount of REM sleep. We conclude that in patients who do not experience clozapine-induced fever, clozapine has strong sleep consolidating effects resulting from an increase in stage 2 NREM sleep.
关于氯氮平（一种具有强镇静特性的非典型抗精神病药物）对夜间睡眠影响的多导睡眠图研究报告的结果并不一致。这些研究大多未纳入基线记录，也未对氯氮平引起的发热进行控制，而发热已知会改变夜间睡眠。我们对10名长期未用药的精神分裂症患者在氯氮平治疗的第一周和第二周开始前及结束时进行了为期2周的纵向多导睡眠图调查。每天测量直肠温度，发热（>37.9摄氏度）的患者被排除。氯氮平显著改善了睡眠连续性。此外，非快速眼动（NREM）睡眠，尤其是2期睡眠显著增加，而4期睡眠和慢波睡眠量显著减少。氯氮平显著增加了快速眼动密度，但未影响快速眼动睡眠量。我们得出结论，在未经历氯氮平引起发热的患者中，氯氮平具有强大的睡眠巩固作用，这是由2期NREM睡眠增加所致。
