Abstract
Objective: To clarify the effects of escitalopram on sleep EEG power in patients with Major depressive disorder (MDD).Method: Polysomnography (PSG) was detected overnight, and blood samples were collected at 4 h intervals over 24 h from 13 male healthy controls and 13 male MDD patients before and after treatment with escitalopram for 8 weeks. The outcome measures included plasma melatonin levels, sleep architecture, and the sleep EEG power ratio.Results: Compared with healthy controls, MDD patients presented abnormalities in the diurnal rhythm of melatonin secretion, including peak phase delayed 3 h and a decrease in plasma melatonin levels at night and an increase at daytime, accompanied by sleep disturbances, a decrease in low-frequency bands and an increase in high-frequency bands, and the dominant right-side brain activity. Several of these abnormalities (abnormalities in the diurnal rhythm of melatonin secretion, partial sleep architecture parameters) persisted for at least the 8-week testing period.Conclusions: Eight weeks of treatment with escitalopram significantly improved subjective sleep perception and depressive symptoms of patients with MDD, and partially improved objective sleep parameters, while the improvement of circadian rhythm of melatonin was limited.
Highlights
Major depressive disorder (MDD) is one of the most prevalent mental health conditions and the leading cause of disability worldwide [1]
There were no significant differences in age, education, and Body Mass Index between Healthy controls (HCs) and MDD patients at baseline (Table 1)
MADRS, HRSD, Hamilton Anxiety scale (HAMA), and CGI-S scores significantly decreased after 8 weeks of escitalopram treatment (p values < 0.05)
Summary
Major depressive disorder (MDD) is one of the most prevalent mental health conditions and the leading cause of disability worldwide [1]. Sleep disturbances are common in depressed patients [9], including a shorter latency to rapid-eye-movement (REM) sleep, increased REM sleep [10], impairments in sleep maintenance, decreased slow-wave sleep (SWS) [11], which were assessed by visually scored polysomnography (PSG). A previous study indicated that spectrum power analyses of EEGs provide a more complete record of brain electrical activity during sleep [14]. A previous study revealed the relationship between emotion and hemispheric asymmetry from the perspective of brain networks based on resting state EEG [17]. These findings were not based on analyses of sleep EEGs. Few studies have investigated whether each frequency band of sleep EEGs is asymmetrical
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