Comparative effects of ziprasidone and quetiapine on sleep physiology measures in patients with major depressive disorder

Abstract

Background Sleep complaints are reported in a large percentage of patients with major depressive disorder (MDD). While subjective complaints of insomnia (problems falling asleep, frequent awakenings during the night, early morning awakening or nonrestorative sleep) represent the most common form of sleep disorder, a subset of depressed patients report hypersomnia, typically associated with anergy, lethargy and fatigue. Quetiapine is an atypical antipsychotic approved for the treatment of schizophrenia, bipolar disorder and along with an antidepressant to treat major depressive disorder. Ziprasidone was the fifth atypical antipsychotic to gain approval (February 2001) in the United States. Method Patients ( n -35) received initial baseline polysomnography evaluations over 2 consecutive nights. Subjects were randomly assigned to either quetiapine (50–100mg/day) or ziprasidone (60–100mg/day) treatment. Foran 8 week double-blind, double-dummy treatment trial. Enrolled patients were required to meet the following criteria: 19–67 years of age with a DSM-IV diagnosis of MDD based on a semistructured clinical interview, a score of≥18 on the 21 item Hamilton Rating scale for depression, and a score of>4 on the 3-HAM-D sleep items. Single-night polysomnograms were conducted at weeks 1, 2, and 8 with depression ratings assessed at baseline and weeks 1, 2, 3, 4, 6 and 8. Conclusion In particular, the prominent effects of quetiapine in shortening sleep latency and increasing total sleep time suggest that this medicament compound may be of particular benefit in the treatment of depression associated with prominent insomnia. The present findings demonstrating beneficial effects of quetiapine on sleep physiology parameters in MDD patients with insomnia…