Psychische Erkrankungen in der Lebensspanne ... - DGPPN

Topic 4 G Affektive Störungen, F3 // Affective disorders, F3
011
Modafinil reduces microsleep during partial sleep deprivation
and improves antidepressant treatment outcome after two weeks
Johannes Beck (UPK Basel, Depressionsforschung, Schweiz)
U. Hemmeter, S. Brand, F. Muheim, M. Hatzinger, E. Holsboer-
Trachsler
Introduction: Sleep deprivation (SD) can induce a prompt decrease
in depressive symptoms within 24 hours. Recovery sleep,
naps and even very short episodes of sleep [termed, microsleep
(MS)] during SD have been shown to provoke a rapid relapse into
depression. This study tested the hypothesis that modafinil reduces
MS during SD and augments antidepressant treatment response.
Method: 28 patients with a major depressive episode age 45.1 ±
12.1 years (mean ± SD) were investigated in a double blind placebo
controlled study design. All patients were treated with mirtazapine.
A partial SD (PSD) was performed after one week. Treatment with
modafinil vs. placebo started during PSD and was maintained over
two weeks. Sleep EEG and MS episodes were recorded with a portable
EEG. Depression severity was assessed using the Hamilton
Depression Rating Scale (HDRS) during and after PSD and at follow-ups
after one and two weeks.
Discussion / Results: Modafinil treated patients showed significantly
reduced MS during PSD (11.63 ± 15.99 min) compared to
the placebo group (47.77 ± 65.31 min). After two weeks of treatment,
the modafinil group showed a significant reduction in REM
density, accompanied by a 6.4-fold higher chance to improve
HDRS-scores with significant differences between groups X2(1)
=4.25 p