Cerebral glucose metabolic response to combined total sleep deprivation and antidepressant treatment in geriatric depression: A randomized, placebo-controlled study

Gwenn S. Smith, Charles F. Reynolds, Patricia R. Houck, Mary Amanda Dew, Joshua Ginsberg, Yilong Ma, Benoit H. Mulsant, Bruce G. Pollock

Research output: Contribution to journalArticlepeer-review

Abstract

A randomized, placebo-controlled study was performed to evaluate whether the onset of the glucose metabolic effects of a selective serotonin reuptake inhibitor (paroxetine) would be accelerated by total sleep deprivation (TSD). Patients were randomly assigned to one of three groups: TSD and paroxetine treatment, TSD and 2 weeks of placebo followed by paroxetine treatment, or 2 weeks of paroxetine treatment. Sixteen elderly depressed patients who met DSM-IV criteria for major depressive disorder and nine age-matched comparison subjects underwent positron emission tomography (PET) studies of cerebral glucose metabolism at baseline, post-TSD (or a normal night's sleep for the paroxetine- only group), post-recovery sleep and 2 weeks post-paroxetine or placebo treatment (patients only). TSD was not consistently associated with a decrease in depressive symptoms between groups nor with decreases in cerebral metabolism in cortical regions that have been associated with rapid and sustained clinical improvement (e.g. anterior cingulate gyrus). The observation of a synergistic antidepressant effect of combined TSD and paroxetine treatment that was observed in a previous "open label" pilot study was not observed in the present randomized study, consistent with lack of a cerebral metabolic effect in brains regions previously shown to be associated with improvement of depressive symptoms.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalPsychiatry Research - Neuroimaging
Volume171
Issue number1
DOIs
StatePublished - Jan 30 2009
Externally publishedYes

Keywords

  • Geriatric depression
  • Glucose metabolism
  • Placebo
  • Positron emission tomography (PET)
  • Selective serotonin reuptake inhibitors
  • Sleep deprivation

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Psychiatry and Mental health

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