Effects of long-term administration of nicotine and fluoxetine on sleep in depressed patients
Received 24 May 2004; accepted 26 August 2004.
Background
The long-term effects of transdermal nicotine and fluoxetine on sleep and major depression were investigated.
Methods
Two independent groups of 12 nonsmoking patients with major depression (Hamilton Rating ≥18) served as subjects. The first group received transdermal nicotine (17.5 mg) while the second group received an oral dose of 20 mg/day of fluoxetine, 5 days weekly for 6 months, 3 days weekly at month 7 and 1 day/week at month 8. From the 9th to the 14th month, once a week a patch without nicotine and an oral placebo substituted nicotine and fluoxetine. Polysomnographic recordings were conducted and depressive symptoms evaluated at baseline and on a monthly basis during medication and during withdrawal.
Results
Nicotine diminished wakefulness and stage 1 and increased REM sleep latency and slow wave sleep throughout the study. A small decrease of REM sleep duration was observed upon nicotine withdrawal. Fluoxetine increased wakefulness, stage 1 duration and REM latency and decreased the sleep efficiency index. Both nicotine and fluoxetine improved mood according to HRS-D scores.
Conclusions
Nicotine and fluoxetine showed equivalent antidepressant efficacy; however, important differences in sleep parameters were observed between nicotine and fluoxetine, both during their administration and following withdrawal.
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aClínica de Trastornos de Sueño, Facultad de Medicina
bDepartamento de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Mexico City, Mexico
Address reprint requests to: Dr. René Drucker-Colín, Depto. de Neurociencias, Instituto de Fisiología Celular, Apdo. Postal 70-600, Universidad Nacional Autónoma de México, 04510 México, D.F., México. Telephone: (52-55) 5550-6662. Fax: (52-55) 5550-0904
ABSTRACT