Effects of a Course of Right Unilateral Ultrabrief Pulse Electroconvulsive Therapy Combined With Venlafaxine on Insomnia Symptoms in Elderly Depressed Patients
| Autor: | Peter B. Rosenquist, W. Vaughn McCall, Robert C. Young, Sarah H. Lisanby, Richard D. Weiner, Matthew V. Rudorfer, Charles H. Kellner, Samuel H. Bailine, Rebecca G. Knapp, Laryssa McCloud, Mary Anne Riley, Mustafa M. Husain, Robert M. Greenberg, Martina Mueller, Shawn M. McClintock, Georgios Petrides, Joan Prudic, Mary Dooley |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Venlafaxine Severity of Illness Index behavioral disciplines and activities Article 03 medical and health sciences 0302 clinical medicine Electroconvulsive therapy Sleep Initiation and Maintenance Disorders mental disorders Severity of illness medicine Insomnia Humans Electroconvulsive Therapy Depression (differential diagnoses) Aged Psychiatric Status Rating Scales Depressive Disorder Major Pulse (signal processing) business.industry Venlafaxine Hydrochloride medicine.disease Combined Modality Therapy Antidepressive Agents nervous system diseases 030227 psychiatry Diagnostic and Statistical Manual of Mental Disorders Psychiatry and Mental health Treatment Outcome Anesthesia Physical therapy Major depressive disorder Antidepressant Female medicine.symptom business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | The Journal of Clinical Psychiatry. 79:78-84 |
| ISSN: | 0160-6689 |
| DOI: | 10.4088/jcp.16m11089 |
| Popis: | OBJECTIVE: Antidepressant medications have a variety of effects on sleep, apart from their antidepressant effects. It is unknown whether electroconvulsive therapy (ECT) has effects on perceived sleep in depressed patients. This secondary analysis examines the effects of ECT on perceived sleep, separate from its antidepressant effects. METHOD: Elderly patients with major depressive disorder, as defined by DSM-IV, received open-label high-dose, right unilateral ultrabrief pulse ECT, combined with venlafaxine, as part of participating on Phase 1 of the NIMH-supported study “Prolonging Remission in Depressed Elderly” (PRIDE). Phase 1 of PRIDE participant enrollment period extended from February 2009 to August 2014. Depression severity was measured with the Hamilton Rating Scale for Depression-24 item (HRSD(24)), and measures of insomnia severity were extracted from the HRSD(24.) Participants were characterized at baseline as either ‘high-insomnia’ or ‘low-insomnia’ subtypes, based upon the sum of the three HRSD(24) sleep items as either 4–6, or 0–3, respectively. Insomnia scores were followed during ECT, and were adjusted for the sum of all the HRSD(24) non-sleep items. Generalized linear models were used for longitudinal analysis of insomnia scores. RESULTS: Two hundred and forty patients participated, with 48.3% in the high-insomnia and 51.7% in the low-insomnia group. Although there was a reduction in the insomnia scores in the high-insomnia group, only 12.4% of them experienced remission of their insomnia after a course of ECT, despite an increase in utilization of sleep aids across the course of ECT, from 8.6% to 23.2%. The degree of improvement in insomnia symptoms paralleled the degree of improvement in non-insomnia symptoms. A “low” amount of improvement on the sum of the HRSD-non-insomnia items (HRSD-sleep) was accompanied by a “low” amount of improvement in insomnia scores (change of −1.6 ± 1.2, p |
| Databáze: | OpenAIRE |
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