Psychiatria pre prax 3/2005

ANTIDEPRESSANT AGENTS AND ARCHITECTURE OF SLEEP IN MAJOR DEPRESSION

The author reviews the current knowledge of changes in sleep architecture associated with use of antidepressants and with major depression in polysomnographic (PSG) studies. REM suppression does not seem to be necessary for antidepressant effectiveness of agents. The SSRIs, venlafaxine and reboxetine worsen sleep efficiency. On the contrary, tricyclic antidepressants, nefazodone, trazodone and mirtazapine show benefitial effect on a quality of sleep. Clinical consequences of sleep disruption in depressive disorder and therapeutic strategy in insomnia are discussed.

Keywords: major depression, antidepressants, sleep disorders, sleep architecture, polysomnography, treatment of insomnia.