Acute, Subchronic and Withdrawal Sleep EEG Changes During Treatment With Paroxetine and Amitriptyline: A Double-Blind Randomized Trial in Major Depression

Staner, Luc; Kerkhofs, Myriam; Detroux, D; Leyman, Shirley; Linkowski, Paul; Mendlewicz, Julien

doi:10.1093/sleep/18.6.470

Cited by 26 publications

(3 citation statements)

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“…Alternatively, these data could be related to a rebound increase in REM sleep, which is reported to occur following SSRI cessation in patients. For example, one study found that paroxetine treatment suppressed REM sleep in humans compared to pre-treatment levels; within just two days of discontinuation, however, total REM sleep increased above pre-medication levels (Staner et al 1995 ). REM rebound was also detected after fluoxetine and citalopram discontinuation (Feige et al 2002 ; Trivedi et al 1999 ; van Bemmel et al 1993 ).…”

Section: Discussionmentioning

confidence: 99%

“…Many psychoactive drugs also affect sleep, including antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are currently the first-line pharmacological treatment of MDD and are known to promote wakefulness and suppress REM sleep by as much as 85% (Argyropoulos et al 2009 ; McCarthy et al 2016 ; Palagini et al 2013 ; Saletu et al 1991 ; Staner et al 1995 ; Trivedi et al 1999 ; Wichniak et al 2017 ). Similar effects have been observed in preclinical studies of the SSRI paroxetine (Gervasoni et al 2002 ; Kantor et al 2017 ; Monaca et al 2003 ; Neckelmann et al 1996 ).…”

Section: Introductionmentioning

confidence: 99%

“…Clinical trials have demonstrated that insomnia and sleeping difficulties occur in a significantly greater proportion of patients stopping SSRI medications than those maintained on-drug (Baldwin et al 2006;Coupland et al 1996;Fava et al 2007;Hindmarch et al 2000;Judge et al 2002;van Geffen et al 2005). Human electroencephalogram (EEG) studies have also shown that SSRI discontinuation can produce a rebound increase in REM sleep (Staner et al 1995). Moreover, daytime somnolence, or the desire to go to sleep during the day, has also been reported in patients undergoing SSRI discontinuation (Black et al 1993;Haddad et al 1998;Zajecka et al 1998).…”

Section: Introductionmentioning

confidence: 99%

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Continuous home cage monitoring of activity and sleep in mice during repeated paroxetine treatment and discontinuation

Collins

Pinacho

Tam³

et al. 2023

Psychopharmacology

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Rationale Non-invasive home cage monitoring is emerging as a valuable tool to assess the effects of experimental interventions on mouse behaviour. A field in which these techniques may prove useful is the study of repeated selective serotonin reuptake inhibitor (SSRI) treatment and discontinuation. SSRI discontinuation syndrome is an under-researched condition that includes the emergence of sleep disturbances following treatment cessation. Objectives We used passive infrared (PIR) monitoring to investigate changes in activity, sleep, and circadian rhythms during repeated treatment with the SSRI paroxetine and its discontinuation in mice. Methods Male mice received paroxetine (10 mg/kg/day, s.c.) for 12 days, then were swapped to saline injections for a 13 day discontinuation period and compared to mice that received saline injections throughout. Mice were continuously tracked using the Continuous Open Mouse Phenotyping of Activity and Sleep Status (COMPASS) system. Results Repeated paroxetine treatment reduced activity and increased behaviourally-defined sleep in the dark phase. These effects recovered to saline-control levels within 24 h of paroxetine cessation, yet there was also evidence of a lengthening of sleep bouts in the dark phase for up to a week following discontinuation. Conclusions This study provides the first example of how continuous non-invasive home cage monitoring can be used to detect objective behavioural changes in activity and sleep during and after drug treatment in mice. These data suggest that effects of paroxetine administration reversed soon after its discontinuation but identified an emergent change in sleep bout duration, which could be used as a biomarker in future preclinical studies to prevent or minimise SSRI discontinuation symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Continuous home cage monitoring of activity and sleep in mice during repeated paroxetine treatment and discontinuation

Collins

Pinacho

Tam³

et al. 2023

Psychopharmacology

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Rapid Tryptophan Depletion, Sleep Electroencephalogram, and Mood in Men With Remitted Depression on Serotonin Reuptake Inhibitors

Moore¹,

Gillin²,

Bhatti³

et al. 1998

Arch Gen Psychiatry

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Background:In previous studies, depletion of brain serotonin by administration of a tryptophan-free amino acid drink (TFD) (1) temporarily reversed the antidepressant effects of selective serotonin reuptake inhibitors (SSRIs) in euthymic patients who had a history of major depression, and (2) enhanced rapid eye movement (REM) sleep in normal volunteers. In this study, we hypothesized that the TFD would not only increase depressive symptoms but also the propensity for REM sleep in euthymic patients treated with SSRIs.

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Paroxetine versus other anti-depressive agents for depression

Purgato

Papola

Gastaldon

et al. 2014

Cochrane Database of Systematic Reviews

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Some possibly clinically meaningful differences between paroxetine and other ADs exist, but no definitive conclusions can be drawn from these findings. In terms of response, there was a moderate quality of evidence that citalopram was better than paroxetine in the acute phase (six to 12 weeks), although only one study contributed data. In terms of early response to treatment (one to four weeks) there was moderate quality of evidence that mirtazapine was better than paroxetine and that paroxetine was better than reboxetine. However there was no clear evidence that paroxetine was better or worse compared with other antidepressants at increasing response to treatment at any time point. Even if some differences were identified, the findings from this review are better thought as hypothesis forming rather than hypothesis testing and it would be reassuring to see the conclusions replicated in future trials. Finally, most of included studies were at unclear or high risk of bias, and were sponsored by the drug industry. The potential for overestimation of treatment effect due to sponsorship bias should be borne in mind.

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Acute, Subchronic and Withdrawal Sleep EEG Changes During Treatment With Paroxetine and Amitriptyline: A Double-Blind Randomized Trial in Major Depression

Cited by 26 publications

References 0 publications

Continuous home cage monitoring of activity and sleep in mice during repeated paroxetine treatment and discontinuation

Continuous home cage monitoring of activity and sleep in mice during repeated paroxetine treatment and discontinuation

Rapid Tryptophan Depletion, Sleep Electroencephalogram, and Mood in Men With Remitted Depression on Serotonin Reuptake Inhibitors

Paroxetine versus other anti-depressive agents for depression

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