Effect of butriptyline on subjective feelings and sleep

Sleep patterns in depression and anxiety: theory and pharmacological effects

Sleep is invariably disrupted in patients who have depression and in patients with anxiety disorders. Depression and anxiety frequently coexist and are associated with disturbances in various neurotransmitters. The authors explore the relationship between sleep and the two disorders as well as the effects of antidepressants and anxiolytics on sleep architecture. The effects on sleep of various neurotransmitter systems implicated in depression and anxiety are outlined. Lastly, various theoretical models are proposed to account for the above mentioned phenomena and further directions for research are suggested.

Drug effects on REM sleep and on endogenous depression

In earlier work REM sleep deprivation (RSD) by arousals improved endogenous depression. This suggested that drugs producing a similar RSD would have antidepressant activity. The arousal RSD was large, persisted for weeks, and was followed by a REM rebound. We call RSD with these properties arousal-type RSD. The present study reviewed literature from 1962 to 1989 on drug REM sleep effects to examine the hypothesis that drugs producing arousal-type RSD improve endogenous depression. The literature reviewed concerned the REM sleep effects of amine precursors, antidepressants, antihistamines, antipsychotics, barbiturates, benzodiazepines, other hypnotics, drugs affecting cholinergic and noradrenergic neurotransmission, ethanol, lithium and narcotics. Four hundred and sixty-eight relevant papers were read and 215 contributed information that could be used in the review. The findings indicated that all drugs producing arousal-type RSD improved endogenous depression. Four drugs that improved endogenous depression did not produce arousal-type RSD.