And Poor Sleep Connection

 

FARMINGTON -- Depression usually is accompanied by sleep problems. Antidepressants may help the depression, but they may also perpetuate poor sleeping patterns. A new study being conducted at the University of Connecticut Health Center will look at two different anti-depressants as they relate to the quality of sleep and daytime performance.

What makes this study unique, said its principal investigator Andrew Winokur, MD, PhD, senior neuropsychopharmacolgist and professor of psychiatry and pharmacology at the Health Center, is that it will not only monitor the quality of sleep but also next-day alertness. Sleep disturbances among patients with depressive disorders often contribute to the physical, psychological, social, emotional and vocational impairment of patients even when they are not diagnosed with a sleep disorder.

“I think it will be very helpful for clinicians when prescribing antidepressants to know their effects on sleep and on next-day performance as well,” he said. “Brain chemistry regulates sleep and different drugs affect sleep in different ways. What we want to determine is which antidepressant allows good sleep and no day-after lethargy,” said Dr Winokur. “Clinicians will then have more information about the drug they are prescribing and can better judge the best treatment for individual patients.”

According to Dr Winokur, sleep disturbances disappear in most patients when the depressive symptoms have been resolved. However, poor sleep patterns may worsen the depressive symptoms and vice versa. “Sleep disturbances and depressive disorders commonly coexist,” said Dr, Winokur, “and sleep disturbances are both risk factors for depressive disorder as well as symptoms of depressive disorders.”

Also, said Dr Winokur, by not treating sleep problems, depression is likely to worsen or relapses may occur. Depressed patients often experience more fatigue affecting their ability to function. They may worry about insomnia and that can lead to a cycle of insomnia, anxiety and self-medication to aid sleep.

By studying the effects of two different compounds frequently prescribed antidepressants, mirtazapine (Remeron®) and fluoxetine (Prozac®), Dr Winokur seeks to learn which is less likely to cause sleep disturbances or leave the patient sleepy during the day.

Dr Winokur will be looking at the antidepressant response as it relates to sleep effectiveness over a 10-week period. Study participants will be asked to spend a total of five non-consecutive nights in the sleep laboratory to have their sleep patterns evaluated. They will also be asked to complete a questionnaire to assess daytime sleepiness and to measure performance and mental sharpness. Routine medical exams and blood tests will be given, and study participants will be compensated.

If you have been diagnosed with major depressive disorder, and antidepressant drug treatment is indicated, you may be eligible to participate. For complete information about this study or other studies related to sleep and depression, call Cathie Witkowski at 860/679-8084, Ellen Gary at 860/679-8085 or call toll free at 877/252-2225. All calls are confidential.