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Impact of escitalopram on nocturnal sleep, day-time sleepiness and performance compared to amitriptyline: a randomized, double-blind, placebo-controlled study in healthy male subjects.

Abstract

INTRODUCTION

Antidepressant drugs vary in their effects on sleep, day-time sedation and performance. Up to now, no data are available for either escitalopram (ESCIT) or amitriptyline (AMI), measuring these by an objective test, such as the MULTIPLE SLEEP LATENCY TEST (MSLT).

SUBJECTS AND METHODS

We therefore investigated the impact of a single evening dose of 10 mg ESCIT on polysomnographically recorded nocturnal sleep, day-time sleepiness and performance in comparison to 75 mg AMI and placebo (PLAC) in healthy male subjects.

RESULTS

Both antidepressants significantly suppressed REM sleep (p<0.001). Although polysomnographically measured sleep continuity was impaired after ESCIT (p=0.006), subjective estimates of sleep parameters did not differ. Periodic limb movements (PLMS) were increased after AMI (p<0.001) but not after ESCIT. Processing speed and performance were enhanced after ESCIT compared with AMI (p=0.011), but not with PLAC. Next-day alertness was significantly impaired by AMI (p=0.012), but not by ESCIT. Mean day-time sleep onset latencies increased significantly after evening ESCIT (p<0.001). In contrast, AMI led to a pronounced increase of day-time sleepiness (p=0.007).

DISCUSSION

This study demonstrates that single evening doses of either AMI or ESCIT exhibit different effects on next-day vigilance and alertness in terms of a slightly stimulating effect of ESCIT and a significant reduction after AMI.

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  • Authors+Show Affiliations

    ,

    Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany. john-peter.doerr@uniklinik-freiburg.de

    , , , , , ,

    Source

    Pharmacopsychiatry 43:5 2010 Jul pg 166-73

    MeSH

    Adult
    Amitriptyline
    Antidepressive Agents, Tricyclic
    Circadian Rhythm
    Citalopram
    Cross-Over Studies
    Double-Blind Method
    Electroencephalography
    Humans
    Male
    Polysomnography
    Psychomotor Performance
    Serotonin Uptake Inhibitors
    Sleep
    Sleep Stages
    Time Factors
    Young Adult

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20603788

    Citation

    Doerr, J P., et al. "Impact of Escitalopram On Nocturnal Sleep, Day-time Sleepiness and Performance Compared to Amitriptyline: a Randomized, Double-blind, Placebo-controlled Study in Healthy Male Subjects." Pharmacopsychiatry, vol. 43, no. 5, 2010, pp. 166-73.
    Doerr JP, Spiegelhalder K, Petzold F, et al. Impact of escitalopram on nocturnal sleep, day-time sleepiness and performance compared to amitriptyline: a randomized, double-blind, placebo-controlled study in healthy male subjects. Pharmacopsychiatry. 2010;43(5):166-73.
    Doerr, J. P., Spiegelhalder, K., Petzold, F., Feige, B., Hirscher, V., Kaufmann, R., ... Voderholzer, U. (2010). Impact of escitalopram on nocturnal sleep, day-time sleepiness and performance compared to amitriptyline: a randomized, double-blind, placebo-controlled study in healthy male subjects. Pharmacopsychiatry, 43(5), pp. 166-73. doi:10.1055/s-0030-1249049.
    Doerr JP, et al. Impact of Escitalopram On Nocturnal Sleep, Day-time Sleepiness and Performance Compared to Amitriptyline: a Randomized, Double-blind, Placebo-controlled Study in Healthy Male Subjects. Pharmacopsychiatry. 2010;43(5):166-73. PubMed PMID: 20603788.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Impact of escitalopram on nocturnal sleep, day-time sleepiness and performance compared to amitriptyline: a randomized, double-blind, placebo-controlled study in healthy male subjects. AU - Doerr,J P, AU - Spiegelhalder,K, AU - Petzold,F, AU - Feige,B, AU - Hirscher,V, AU - Kaufmann,R, AU - Riemann,D, AU - Voderholzer,U, Y1 - 2010/07/05/ PY - 2010/7/7/entrez PY - 2010/7/7/pubmed PY - 2010/11/3/medline SP - 166 EP - 73 JF - Pharmacopsychiatry JO - Pharmacopsychiatry VL - 43 IS - 5 N2 - INTRODUCTION: Antidepressant drugs vary in their effects on sleep, day-time sedation and performance. Up to now, no data are available for either escitalopram (ESCIT) or amitriptyline (AMI), measuring these by an objective test, such as the MULTIPLE SLEEP LATENCY TEST (MSLT). SUBJECTS AND METHODS: We therefore investigated the impact of a single evening dose of 10 mg ESCIT on polysomnographically recorded nocturnal sleep, day-time sleepiness and performance in comparison to 75 mg AMI and placebo (PLAC) in healthy male subjects. RESULTS: Both antidepressants significantly suppressed REM sleep (p<0.001). Although polysomnographically measured sleep continuity was impaired after ESCIT (p=0.006), subjective estimates of sleep parameters did not differ. Periodic limb movements (PLMS) were increased after AMI (p<0.001) but not after ESCIT. Processing speed and performance were enhanced after ESCIT compared with AMI (p=0.011), but not with PLAC. Next-day alertness was significantly impaired by AMI (p=0.012), but not by ESCIT. Mean day-time sleep onset latencies increased significantly after evening ESCIT (p<0.001). In contrast, AMI led to a pronounced increase of day-time sleepiness (p=0.007). DISCUSSION: This study demonstrates that single evening doses of either AMI or ESCIT exhibit different effects on next-day vigilance and alertness in terms of a slightly stimulating effect of ESCIT and a significant reduction after AMI. SN - 1439-0795 UR - https://www.unboundmedicine.com/medline/citation/20603788/Impact_of_escitalopram_on_nocturnal_sleep_day_time_sleepiness_and_performance_compared_to_amitriptyline:_a_randomized_double_blind_placebo_controlled_study_in_healthy_male_subjects_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0030-1249049 DB - PRIME DP - Unbound Medicine ER -