Abstract
Sleep abnormalities associated with major depressive disorders include an early onset of rapid eye movement (REM) sleep, increased awakenings, reduced slow-wave sleep and increased light, non-restorative sleep. This paper presents a review of the effects of antidepressants on sleep electroencephalogram (EEG) in depression, including tricyclics (TCAs), and selective serotonin re-uptake inhibitors (SSRIs). Studies of the effects of nefazodone, a phenylpiperazine agent that has dual action on serotonin (5-HT1A re-uptake inhibition and 5-HT2 antagonism), are also included. In contrast to TCAs and SSRIs, nefazodone is a non-sedating antidepressant that improves sleep consolidation. Nefazodone also has little effect on REM latency or on total REM time, as reported for trimipramine, iprindole, moclobemide and bupropion. These findings suggest that antidepressant efficacy is not solely tied to REM sleep suppression.
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