Improved Sleep Continuity and Increased Slow Wave Sleep and REM Latency During Ziprasidone Treatment

Cohrs, Stefan; Meier, Andreas; Neumann, Anna-Catharina; Jordan, Wolfgang; Rüther, Eckart; Rodenbeck, Andrea

doi:10.4088/jcp.v66n0805

Cited by 52 publications

(28 citation statements)

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“…Quetiapine 25 and 100 mg led to significant improvement versus placebo in PSG sleep onset latency, sleep time and sleep efficiency, and reported sleep quality at both doses in both experimental conditions (Cohrs et al, 2004). Similarly, ziprasidone 40 mg significantly improved PSG total sleep time, sleep efficiency and the number of awakenings compared with placebo, as well as self-reported number of awakenings, sleep time and sleep quality (Cohrs et al, 2005).…”

Section: Sedating Effects That Could Improve Insomniamentioning

confidence: 86%

“…Two double-blind, placebo-controlled studies in healthy participants with identical methodology examined the effects of ziprasidone (12 participants) and quetiapine (14 participants) on sleep (Cohrs et al, 2004(Cohrs et al, , 2005. These studies evaluated the effects of these medications on an undisturbed night and on a night where sleep was disturbed with noise.…”

Section: Sedating Effects That Could Improve Insomniamentioning

confidence: 99%

“…As REM sleep suppression may Table 2 Polysomnographic sleep effects of antipsychotic medications (Forsman and Ohman, 1977;He and Richardson, 1995;Ereshefsky, 1996;Hinze-Selch et al, 1997;Prakash et al, 1997;Maixner et al, 1998;Salin-Pascual et al, 1999, 2004Lee et al, 2001;Yamashita et al, 2002;Sharpley et al, 2003;Cohrs et al, 2004Cohrs et al, , 2005Tassaneeyakul et al, 2005;Markowitz et al, 2006) T max (hours) T be mediated by agonist effects at the 5HT 1A receptor and cholinergic antagonism, as well as possibly other mechanisms, it is harder to predict the degree to which this will occur based on the pharmacologic-binding profile (Table 2). Relatively greater REM suppression, however, might be expected with ziprasidone and aripiprazole owing to their effects on the 5HT 1A receptor and olanzapine, clozapine and chlorpromazine based on their anticholinergic effects.…”

Section: Suppression Of Rapid Eye Movement Sleepmentioning

confidence: 99%

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Effects of antipsychotic medications on sleep in schizophrenia

Krystal¹,

Goforth²,

Roth

2008

International Clinical Psychopharmacology

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Schizophrenia is often accompanied by sleep problems. Evidence exists that these sleep difficulties have significant effects on individuals with this disorder. The mainstay of treatment for this condition is the administration of medications that have effects on neurotransmitter systems, which play an important role in sleep-wake function, including histamine, acetylcholine, serotonin, norepinephrine and dopamine. Little systematic attention, however, has been paid to how the sleep effects of these agents might play a role in the course of treatment, function and quality of life of schizophrenia patients. Schizophrenia medications can improve sleep problems and reverse the sleep architectural derangements that are common among patients with schizophrenia and, therefore, have the potential to improve the quality of life and functional capacity of the patient. Conversely, some sleep-wake effects of these medications can impair patient function and quality of life. In this study, we review the effects of schizophrenia medications and discuss their relevance to optimizing the clinical treatment of people with schizophrenia with regard to sleep-wake function.

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Section: Sedating Effects That Could Improve Insomniamentioning

confidence: 86%

Section: Sedating Effects That Could Improve Insomniamentioning

confidence: 99%

Section: Suppression Of Rapid Eye Movement Sleepmentioning

confidence: 99%

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Effects of antipsychotic medications on sleep in schizophrenia

Krystal¹,

Goforth²,

Roth

2008

International Clinical Psychopharmacology

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“…Multiple imputation regression analysis was used to approximate missing data for PSG and clinical measures for 6 of the 14 patients who missed their day 28-31 PSG, and for three who also missed their day 28-31 clinical assessment. In order to detect an improvement in REM sleep of approximately 45% (the published difference in REM sleep between placebo-and ziprasidone-treated healthy volunteers) [Cohrs et al 2005], 7 patients were needed in each arm, for a total sample size of 14, based on a one-sided normal distribution paired t-test analysis with a significance of 0.05 and 80% power. A sample size of 20 patients was used to allow for patient dropout.…”

Section: Discussionmentioning

confidence: 99%

Sleep architecture in ziprasidone-treated bipolar depression: a pilot study

Baskaran

Summers

Willing

et al. 2012

Therapeutic Advances in Psychopharmacology

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Objectives: This study investigated the effect of ziprasidone augmentation therapy on sleep architecture in bipolar depression. Methods: We conducted a double-blind, randomized, placebo-controlled clinical pilot trial of ziprasidone versus placebo in Diagnostic and Statistical Manual of Mental Disorders, fourth edition bipolar disorder with current major depressive episode. The effects during acute (2-5 days) and continuation treatment (28-31 days) were measured. Main outcomes were sleep architecture variables including rapid eye movement sleep (REM) and slow wave sleep (SWS) measured by polysomnography. Secondary outcomes included subjective sleep quality measures and illness severity measures including the 17-item Hamilton Depression Rating Scale (HAMD-17), Montgomery Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAMA) and Clinical Global Illness Severity (CGI-S) scores. Results:The completer analysis comprised of 14 patients (ziprasidone, N = 8 and placebo, N = 6). Latency to REM, duration of SWS, duration of stage 2 sleep, total sleep time, onset to sleep latency, number of awakenings and overall sleep efficiency significantly improved in ziprasidone-treated participants over placebo. CGI-S and HAMA scores also significantly improved. No significant difference between treatment groups was seen on the HAMD-17, MADRS or in self-reported sleep quality. Increase in SWS duration significantly correlated with improvement in CGI-S, however, this finding did not withstand Bonferroni correction. Conclusion: Adjunctive ziprasidone treatment alters sleep architecture in patients with bipolar depression, which may partially explain its mechanism of action and merits further investigation.

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“…Unter Risperdal hingegen ließ sich keine signifikante Veränderung nachweisen. Sowohl Quetiapin als auch Ziprasidon haben bei Gesunden eine signifikante Tiefschlaf fördernde Wirkung [7,8]. Diese Ergebnisse lassen sich bei Patienten mit bipolarer Störung/Schizophrenie reproduzieren [5,20].…”

Section: Behandlung Von Schlafstörungen Bei Psychischen Erkrankungenunclassified

Störungen des Tiefschlafs und psychische Erkrankungen

2011

Somnologie

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Wach Schlafstadium 1 Wach REM Schlafstadium 2 SS 1 SS 2 SWS Schlafstadium 3 Schlafstadium 4 a b Abb. 1 8 a Polysomnogramm eines gesunden, jungen Erwachsenen sowie b die verschiedenen EEGFrequenzen in den jeweiligen Schlafstadien (SS). REM "rapid eye movement", SWS "slow-wave sleep" Die Klage über mangelnden Tiefschlaf bzw. nichterholsamen Schlaf in Verbindung mit Ein-und Durchschlafstörungen (Insomnien) gehört zu den häufigsten gesundheitlichen Beschwerden überhaupt. Mittlerweile differenziert die moderne Schlafmedizin mehr als 80 verschiedene Schlafstörungen. Neben den bekanntesten schlafmedizinischen Erkrankungen wie dem Schlafapnoesyndrom oder dem Restless-legs-Syndrom können Schlafstörungen auch nichtorganischer und v. a. psychiatrischer Genese sein. So geben 90% aller depressiver Patienten im Rahmen ihrer Erkrankung Schlafstö-rungen an [16]. Eine Insomnie ist zusätz-lich ein Frühwarnsymptom für das erneute Auftreten einer Depression bei remittierten Patienten [9]. Verschiedene epidemiologische Studien kommen zu dem Ergebnis, dass ca. 8-11% der Bevölkerung an behandlungsbedürftigen chronischen Insomnien leidet [32]. Auch das Risiko an einer Depression zu erkranken, erscheint bei nahezu allen schlafmedizinischen Erkrankungen erhöht [52]. Bedeutung und Physiologie des Tiefschlafs Der normale Schlaf besteht nach international gültigen Klassifikationen aus 4 Schlafstadien im Non-REM-Schlaf (NREM, Stadium 1 bis 4) und dem REMSchlaf (. Abb. 1). In der 1. Nachthälfte überwiegen der NREM-und insbesondere der Tiefschlafanteil, während dieser in der 2. Nachthälfte ab-und der REMSchlaf-Anteil zunimmt. Im Tiefschlaf besteht eine hochamplitudige (>75 µV) δ-Aktivität über mehr als 20% (Stadium 3) bzw. mehr als 50% (Stadium 4) einer Epoche. Nach den neuen AASM (American Academy of Sleep Medicine) -Kriterien werden die Tiefschlafstadien 3 und 4 zu einem Schlafstadium -dem sog. SWS-Stadium ("slow-wave sleep") -zusammengefasst [1]. Neben äußeren Faktoren wie Licht, Koffein oder Schichtarbeit wird häufig der Faktor Alter unterschätzt. Bereits zwischen dem 20. und 40. Lebensjahr sinkt der Tiefschlafanteil deutlich und bei älteren Menschen fehlt er oft vollständig. Neben einer Reduktion der Herzfrequenz, des Blutdrucks, der Sympathikusaktivierung und des Glukosemetabolismus im Tiefschlaf kommt es im Schlaf außerdem zu einer Vielzahl an endokrinologischen und immunologischen Veränderungen [51]. Die Kortisolkonzentration hat ihr Minimum in der 1. Nachthälfte. Nach dem Ende der 2. REM-Phase steigt die Konzentration wieder an und erreicht nach dem Aufwachen ihr Maximum. Die Konzentration von Wachstumshormon erreicht ihr Maximum in der Regel während der 1. Tiefschlafphase. Beide Systeme interagieren zudem erhöht die Applikation von Ghrelin, einem endogenen Liganden am GH-Sekretagog (GHS)-Rezeptor bei Gesunden selbst den Tiefschlaf [58]. So führt die Gabe von Dieser Artikel wurde erstpubliziert in Der Nervenarzt 2010 (81): 347-354. Es handelt sich hierbei um eine korrigierte Version. 226 | Somnologie - Schlafforschung und Schlafmedizin...

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Improved Sleep Continuity and Increased Slow Wave Sleep and REM Latency During Ziprasidone Treatment

Cited by 52 publications

References 0 publications

Effects of antipsychotic medications on sleep in schizophrenia

Effects of antipsychotic medications on sleep in schizophrenia

Sleep architecture in ziprasidone-treated bipolar depression: a pilot study

Störungen des Tiefschlafs und psychische Erkrankungen

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