The clinical response to total sleep deprivation and recovery sleep in geriatric depression: potential indicators of antidepressant treatment outcome

Dec 6, 2000Psychiatry research

How sleep loss and recovery sleep relate to treatment results in older adults with depression

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Abstract

A significant correlation was found between the change in core depressive symptoms after recovery sleep and the Hamilton depression rating scale score at 12 weeks.

Change in the Hamilton depression rating scale (HDRS) core symptoms after recovery sleep may predict clinical outcomes after 12 weeks of antidepressant treatment.
No significant correlation was observed between changes in HDRS scores after 36 hours of total sleep deprivation and the 12-week outcomes.
The findings suggest that symptom reduction following recovery sleep is more indicative of treatment response than changes observed after sleep deprivation.

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The clinical response to antidepressant treatment in late-life depression is often delayed and highly variable. Better indicators of antidepressant efficacy are needed early in the course of treatment, so that augmentation strategies or alternative treatments may be initiated. The goal of this study was to evaluate whether the change in the Hamilton depression rating scale (HDRS) after 36 h of total sleep deprivation (TSD) and recovery sleep predicted clinical outcome after 12 weeks of antidepressant treatment, and whether greater predictive value was observed in certain aspects of depressive symptomology. Fifteen elderly patients diagnosed with major depression underwent combined treatment with an initial 36 hours of TSD and a 12-week trial with the antidepressant paroxetine. Six HDRS subscores were evaluated with respect to how the changes after TSD and after one night of recovery sleep correlated with HDRS scores after 12 weeks of treatment. A significant correlation was obtained between the change in the core depressive symptomology subscale from baseline to recovery sleep and the HDRS score at 12 weeks, but the correlation was not significant when evaluating the change from baseline to TSD. These results indicate that the decrease in symptoms after recovery sleep compared with baseline levels (indicating the persistence of the antidepressant response), rather than the symptom reduction after TSD, has greater predictive value with respect to treatment outcome.

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The clinical response to total sleep deprivation and recovery sleep in geriatric depression: potential indicators of antidepressant treatment outcome

Abstract

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