Document Detail


Effects of clozapine on sleep in bipolar and schizoaffective disorders.
MedLine Citation:
PMID:  15610918     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Sleep disturbances are strongly associated with mood disorders, although the majority of data have been obtained in patients with major depressive disorder. Studies reporting results in bipolar disorder are few, and results have not been consistent. Clozapine is a prototype of atypical antipsychotics, which is effective in improving symptoms of manic episodes in patients with bipolar disorder, or schizoaffective disorder, bipolar type and has been shown to influence sleep in other psychiatric disorders. The present study evaluated the sleep effects of clozapine in bipolar and schizoaffective disorders. METHODS: Participants were 11 women and 4 men (range:28-53 years of age, mean 40.9+/-8.6 years), all with a history of mania by DSM-IV criteria for either bipolar I disorder or schizoaffective disorder, bipolar type. They participated in a sleep study at baseline and again after 6 months initiation of clozapine add-on therapy. RESULTS: Sleep latency was longer on clozapine and the number of awakenings were increased, whereas time in bed (TIB) and total sleep period (TSP) were increased (range: F=6.2-17.9; df=l,12; p<0.05). Although none of the individual sleep stage showed significant treatment changes, both Stage 2 and slow-wave sleep were increased and Stage 2 decreased on clozapine. Subjective sleep measures improved on clozapine with a small but significant improvement in how rested patients felt upon awakening (t=-2.1; df=26; p<0.05). CONCLUSION: Clozapine prolonged sleep latency, improved restedness, and increased total sleep time. Although lack of a control group limits interpretation of these results, they are in general agreement with studies in other psychiatric populations, and support the view that clozapine is primarily a NREM sleep enhancer. The improvement in restedness may be of positive clinical consequence.
Authors:
Roseanne Armitage; Darwynn Cole; Trisha Suppes; Mehmet E Ozcan
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Progress in neuro-psychopharmacology & biological psychiatry     Volume:  28     ISSN:  0278-5846     ISO Abbreviation:  Prog. Neuropsychopharmacol. Biol. Psychiatry     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-12-21     Completed Date:  2005-02-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8211617     Medline TA:  Prog Neuropsychopharmacol Biol Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  1065-70     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, Sleep Study Unit, The University of Texas Southwestern Medical Center, 2201 Inwood Road, Dallas, TX 75235, USA. Roseanne.Armitage@med.umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Antipsychotic Agents / therapeutic use*
Bipolar Disorder / complications*,  psychology
Clozapine / therapeutic use*
Dose-Response Relationship, Drug
Female
Humans
Male
Middle Aged
Polysomnography
Psychiatric Status Rating Scales
Psychotic Disorders / complications*,  psychology
Sleep Disorders / drug therapy*,  etiology*
Sleep Stages / drug effects
Grant Support
ID/Acronym/Agency:
MH-53799/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 5786-21-0/Clozapine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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