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my personal edition > sleep disorders > news
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DGReview
Nefazodone Improves Sleep in Patients with Major Depression
A DGReview of :"The Effects of Psychotherapy, Nefazodone, and Their Combination on Subjective Assessment of Disturbed Sleep in Chronic Depression"
Sleep
03/28/2003
By Veronica Rose
Patients with depression who suffer disturbed sleep patterns may be helped with nefazodone therapy.
Researchers from several universities across the United States compared the effects of psychotherapy, nefazodone and their combination on subjective measures of sleep in patients with major depression.
A total of 484 patients were randomised to be treated for 12 weeks by one of the three methods in parallel at 12 academic institutions. All patients had met the Diagnostic and Statistical Manual - Revision IV criteria for one of three forms of major depression.
Therapists provided 16 to 20 psychotherapy sessions following a standardised treatment manual for Cognitive Behavioural Analysis System of Psychotherapy (CBASP). This was a variant of cognitive psychotherapy, which had been developed for chronic depression.
Open-label nefazodone 300-600 mg daily in two divided doses provided the pharmacotherapy. The third treatment method consisted of a combination of both therapies. Clinical management visits were limited to 15-20 minutes following a standardised protocol.
The 24-hour Hamilton Rating Scale for Depression (HRSD) and the 30-item Inventory of Depressive Symptomatology - Self-Rating determined the outcome for depression. Patients maintained daily sleep diaries, which were, completed a week prior to HRSD assessments at baseline and after 1,2,3,4,8 and 12 weeks of treatment. They were then used to measure the sleep outcome prospectively.
Researchers established that "nefazodone and CBASP used singly had a comparable impact on global measures of depression outcome, but only monotherapy with nefazodone improved total sleep time and early morning awakening." However they also noted that there were significant improvements in sleep quality, time awake after sleep onset, latency to sleep onset and sleep efficiency, all of which were present in each of the therapeutic groups.
These improvements were noted by researchers to have occurred earlier in the treatment for patients receiving nefazodone alone or combined with CBASP.
Sleep 2003;26:02:130-136.
"The Effects of Psychotherapy, Nefazodone, and Their Combination on Subjective Assessment of Disturbed Sleep in Chronic Depression"
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