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      Nefazodone Improves Sleep Early In Depression Therapy

      A DGReview of :"Randomised controlled study of sleep after nefazodone or paroxetine treatment in out-patients with depression"
      British Journal of Psychiatry

      06/11/2002
      By Elda Hauschildt


      Nefazodone improves sleep during the early stages of treatment in patients with moderate to severe depression, in comparison with paroxetine.

      University of Bristol researchers from the England report the effects are seen within the first two weeks of therapy. Response then diminishes.

      They point out that the effects of antidepressants on sleep are clinically important. It is known that selective serotonin reuptake inhibitors disturb sleep and 5-hydroxytryptamine receptor-blocking compounds can enhance the quality of sleep.

      Investigators randomised 40 depression patients to either paroxetine (20 milligrams to 40 mg per day) or nefazodone (400 mg to 600 mg per day) for eight weeks. Objective and subjective quality of sleep and depression measures throughout the trial period.

      It was observed that nefazodone therapy significantly increased objective sleep efficiency and also increased total sleep time. Subjective sleep was improved on days three and 10 in patients in the nefazodone group.

      The researchers point out that sleep efficacy was decreased early in treatment for patients receiving paroxetine. Some sleep disruption remained at week eight.

      They also note that paroxetine, but not nefazodone, produced marked suppression of rapid eye movement (REM) sleep.
      British Journal of Psychiatry, 2002; 180: 528-535. "Randomised controlled study of sleep after nefazodone or paroxetine treatment in out-patients with depression"

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