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Accelerating response in geriatric depression: A pilot study combining sleep deprivation and paroxetine
Author(s) -
Bump Gregory M.,
Reynolds Charles F.,
Smith Gwenn,
Pollock Bruce G.,
Dew Mary Amanda,
Mazumdar Sati,
Geary Matthew,
Houck Patricia R.,
Kupfer David J.
Publication year - 1997
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/(sici)1520-6394(1997)6:3<113::aid-da4>3.0.co;2-e
Subject(s) - paroxetine , sleep deprivation , depression (economics) , antidepressant , geriatric depression scale , medicine , hamilton rating scale for depression , rating scale , sleep (system call) , major depressive disorder , psychiatry , psychology , clinical trial , depressive symptoms , circadian rhythm , mood , anxiety , developmental psychology , macroeconomics , computer science , economics , operating system
Elderly depressed patients often require an average of 12 weeks of pharmacotherapy before attaining remission. The delay between treatment initiation and remission may decrease compliance and prolongs suffering; hence, interventions that decrease the time to onset of antidepressant activity are needed. Our objective was to evaluate, in an open trial, the use of one night of total sleep deprivation combined with paroxetine to accelerate antidepressant response in elderly patients. Thirteen elderly patients with major depression were sleep‐deprived for one night and started paroxetine on the night of recovery sleep. Patients were followed for twelve weeks, and clinical improvement was rated using the 17‐item Hamilton Depression Rating Scale and a version of the Hamilton modified for sleep deprivation studies. 8/13 (62%) patients experienced significant improvement of depressive symptoms by 2 weeks. Within 12 weeks 11/13 (85%) patients responded to the combination of sleep deprivation and paroxetine. Median response time was 2 weeks. Clinical response at 12 weeks was correlated with changes in Sleep Deprivation Depression Rating Scale Scores between baseline and recovery sleep. In an open trial, the combined use of total sleep deprivation and paroxetine appears to be an effective method for speeding the onset of clinical antidepressant activity in geriatric depression and for improving early recognition of non‐response. Depression and Anxiety 6:113–118, 1997. © 1997 Wiley‐Liss, Inc.