The effects of paroxetine and nefazodone on sleep: a placebo controlled trial (original) (raw)

Abstract

We studied the effect of acute (1 day) and subacute (16 days) administration of the new antidepressant, nefazodone (400 mg daily), and the selective serotonin re-uptake inhibitor (SSRI), paroxetine (30 mg daily), on the sleep polysomnogram of 37 healthy volunteers using a random allocation, double-blind, placebo-controlled design. Compared to placebo, paroxetine lowered rapid eye movement (REM) sleep and increased REM latency. In addition, paroxetine increased awakenings and reduced Actual Sleep Time and Sleep Efficiency. In contrast, nefazodone did not alter REM sleep and had little effect on measures of sleep continuity. We conclude that in contrast to typical SSRIs, nefazodone administration has little effect on sleep architecture in healthy volunteers.

Access this article

Log in via an institution

Subscribe and save

• Starting from 10 chapters or articles per month
• Access and download chapters and articles from more than 300k books and 2,500 journals
• Cancel anytime View plans

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

• Armitage R, Rush AJ, Trivedi M, Cain J, Roffwarg HP (1994) The effects of nefazodone on sleep architecture in depression. Neuropsychopharmacology 10:123–127
  Google Scholar
• Friston KJ, Sharpley AL, Solomon RA, Cowen PJ (1989) Lithium increases slow wave sleep: possible mediation by brain 5-HT2 receptors? Psychopharmacology 98:139–140
  Google Scholar
• Gillin JC, Wyatt RJ, Fram D, Snyder F (1978) The relationship between changes in REM sleep and clinical improvement in depressed patients treated with amitriptyline. Psychopharmacology 59:267–272
  Google Scholar
• Kahn RS, Wetzler S (1991)_m_-Chlorophenylpiperazine as a probe of serotonin function. Biol Psychiatry 30:1139–1166
  Google Scholar
• Katsuda Y, Walsh AES, Ware CJ, Cowen PJ, Sharpley AL (1993) meta-chlorophenylpiperazine decreases slow-wave sleep in humans. Biol Psychiatry 33:49–51
  Google Scholar
• Kupfer DJ, Spiker DG, Coble PA, Neil JF, Ulrich R, Shaw DH (1981) Sleep and treatment prediction in endogenous depression. Am J Psychiatry 138:429–433
  Google Scholar
• Kupfer DJ, Perel JM, Pollock BG, Nathan RS, Grochocinski BJ, Wilson MJ, McEacharn AB (1991) Fluvoxamine versus desipramine comparative polysomnographic effects. Biol Psychiatry 29:23–40
  Google Scholar
• Lawlor BA, Newhouse PA, Balkin TJ, Molchan SE, Mellow AM, Murphy DL, Sunderland T (1991) A preliminary study of the effects of night-time administration of the serotonin agonist, m-CPP, on sleep architecture and behaviour in healthy volunteers. Biol Psychiatry 29:281–286
  Google Scholar
• Montgomery I, Oswald I, Morgan K, Adam K (1983) Trazodone enhances sleep in subjective quality but not in objective duration. Br J Clin Pharmacol 16:139–144
  Google Scholar
• Monti JM (1989) Effects of a reversible monoamine oxidase-A inhibitor (moclobemide) on sleep of depressed patients. Br J Psychiatry 155:61–65
  Google Scholar
• Nicholson AN, Pascoe PA (1986) 5-Hydroxytryptamine and noradrenaline uptake inhibition: studies on sleep in man. Neuropharmacology 25:1079–1083
  Google Scholar
• Nicholson AN, Pascoe PA (1991) Monoaminergic transmission and sleep in man. In: Idzikowski C, Cowen PJ (eds) Serotonin, sleep and mental disorder. Wrightson Biomedical Publishing, Winchester, pp 215–226
  Google Scholar
• Nofzinger EA, Reynolds CF III, Thas ME, Frank E, Jennings JR, Fasiczka AL, Sullivan LR, Kupfer BJ (1995) REM sleep enhancement by bupropion in depressed men. Am J Psychiatry 152:274–276
  Google Scholar
• Oswald I, Adam K (1986) Effects of paroxetine on human sleep. Br J Clin Pharmacol 22:97–99
  Google Scholar
• Oswald I, Adam K, Allen S, Burack R, Spence M, Thacore V (1974) Alpha adrenergic blocker, thymoxamine, and mesoridazine both increase human REM sleep duration. Sleep Res 3:62
  Google Scholar
• Rechtschaffen A, Kales A (1968) A manual of standardised terminology, techniques and scoring system for sleep stages of human subjects. Los Angeles Brain Information Service, Brain Research Institute, Univesity of California
• Reynolds CF III, Kupfer DJ (1987) Sleep research in affective illness: state of the art circa 1987. Sleep 10:199–215
  Google Scholar
• Rickels K, Schweizer E, Clary C, Fox I, Weise C (1994) Nefazodone and imipramine in major depression: a placebo controlled trial. Br J Psychiatry 164:802–805
  Google Scholar
• Sharpley AL, Cowen PJ (1995) Effect of pharmacologic treatments on the sleep of depressed patients. Biol Psychiatry 37:85–98
  Google Scholar
• Sharpley AL, Walsh AES, Cowen PJ (1992) Nefazodone — a novel antidepressant — may increase REM sleep. Biol Psychiatry 31:1070–1073
  Google Scholar
• Sharpley AL, Elliott JM, Attenburrow MJ, Cowen PJ (1994) Slow wave sleep in humans: role of 5-HT2A and 5-HT2C receptors. Neuropharmacology 33 [3/4]:467–471
  Google Scholar
• Solomon RA, Sharpley AL, Cowen PJ (1989) Increased slow wave sleep with 5-HT2 receptor antagonists: detection by ambulatory EEG monitoring and automatic sleep stage analysis. J Psychopharmacol 3:125–129
  Google Scholar
• Ware JC, Rose V, McBrayer R (1991) The effects of nefazodone, trazodone, buspirone and placebo on sleep and sleep related penile erections (NPT) in normal subjects. Sleep Res 20:91
  Google Scholar
• Yocca FD, Hyslop DK, Taylor DP (1985) Nefazodone: a potential broad spectrum antidepressant. Transact Am Soc Neurochem 16:115
  Google Scholar

Download references

Author information

Authors and Affiliations

1. University Department of Psychiatry, Littlemore Hospital, OX4 4XN, Oxford, UK
   A. L. Sharpley, D. J. Williamson, M. E. J. Attenburrow, G. Pearson, P. Sargent & P. J. Cowen

Authors

1. A. L. Sharpley
2. D. J. Williamson
3. M. E. J. Attenburrow
4. G. Pearson
5. P. Sargent
6. P. J. Cowen

Rights and permissions

About this article

Cite this article

Sharpley, A.L., Williamson, D.J., Attenburrow, M.E.J. et al. The effects of paroxetine and nefazodone on sleep: a placebo controlled trial.Psychopharmacology 126, 50–54 (1996). https://doi.org/10.1007/BF02246410

Download citation

• Received: 11 October 1995
• Revised: 05 February 1996
• Issue date: July 1996
• DOI: https://doi.org/10.1007/BF02246410

Key words