Reboxetine Induces Similar Sleep-EEG Changes Like SSRI’s in Patients with Depression

Background: Reboxetine is a novel selective noradrenaline reuptake inhibitor. The antidepressive properties of the substance are established. Methods: The influence of reboxetine on the sleep-EEG of eight patients with depression HAMD (mean ± SD) 19.7 ± 1.5 (5 women, 3 men; age range 31 to 75 years) was investigated. Sleep EEG was examined twice. The first examination was performed before starting active medication. The second examination was subsequently performed when patients received 8 to 10 mg reboxetine per day. Results: Conventional sleep-EEG analysis showed a significant increase in intermittent wakefulness and sleep stage 2 and a decrease in sleep efficiency and REM time. Under reboxetine no significant changes were observed in sleep-EEG spectral analysis. Conclusion: Our results indicate, that reboxetine induces sleep-EEG changes similar to those after selective serotonin reuptake inhibitors (SSRI’s) by increasing intermittent wakefulness and decreasing REM time.

References

• 1 Ansseau M, Kupfer D J, Reynolds C F, 3rd, Coble P A. ”Paradoxical” shortening of REM latency on first recording night in major depressive disorder: clinical and polysomnographic correlates.  Biol Psychiatry. 1985;  20 135-145
• 2 Armitage R, Trivedi M, Rush A J. Fluoxetine and oculomotor activity during sleep in depressed patients.  Neuropsychopharmacology.. 1995;  12 159-165
• 3 Dencker S J. The need for new and better antidepressants: Reboxetineoxetine a new option.  Acta Psychiatr Scand. 2000;  402 (suppl) 6-11
• 4 Farina B, Della Marca G, Mennuni G, Mazza S, De Risio S, Di Giannantonio M. The effects of reboxetine on human sleep architecture in depression: preliminary results.  J Affect Disord. 2002;  71 273-275
• 5 Feige B, Voderholzer U, Riemann D, Dittmann R, Hohagen F, Berger M. Fluoxetine and sleep EEG. Effects of a single dose, subchronic treatment, and discontinuation in healthy subjects.  Neuropsychopharmacology. 2002;  26 246-258
• 6 Hobson J A, Stickgold R, Pace-Schott E F. The neuropsychology of REM sleep dreaming.  Neuroreport. 1998;  9 R1-14
• 7 Hori T, Sugita Y, Koga E, Shirakawa S, Inoue K, Uchida S, Kuwahara H, Kousaka M, Kobayashi T, Tsuji Y, Terashima M, Fukuda K, Fukuda N. Proposed supplements and amendments to ‘A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects’, the Rechtschaffen & Kales (1968) standard.  Psychiatry Clin Neurosci. 2001;  55 305-310
• 8 Kupfer D J, Ehlers C L, Frank E, Grochocinski V J, McEachran A B. EEG sleep profiles and recurrent depression.  Biol Psychiatry. 1991;  30 641-655
• 9 Nicholson A N, Pascoe P A. 5-Hydroxytryptamine and noradrenaline uptake inhibition: studies on sleep in man.  Neuropharmacology. 1986;  25 1079-1083
• 10 Nofzinger E A, Reynolds C F, 3rd, Thase M E, Frank E, Jennings J R, Fasiczka A L, Sullivan L R, Kupfer D J. REM sleep enhancement by bupropion in depressed men.  Am J Psychiatry. 1995;  152 274-276
• 11 Riemann D, Voderholzer U, Cohrs S, Rodenbeck A, Hajak G, Rüther E, Wiegand M H, Laakman G, Baghai T, Fischer W, Hoffmann M, Hohagen F, Mayer G, Berger M. Trimipramine in primary insomnia: results of a polysomnographic double-blind controlled study.  Pharmacopsychiatry.. 2002;  35 165-174
• 12 Rush A J, Armitage R, Gillin J C, Yonkers K A, Winokur A, Moldofsky H, Vogel G W, Kaplita S B, Fleming J B, Montplaisir J, Erman M K, Albala B J, McQuade R D. Comparative effects of nefazodone and fluoxetine on sleep in outpatients with major depressive disorder.  Biol Psychiatry. 1998;  44 3-14
• 13 Silvestri R, Pace-Schott E F, Gersh T, Stickgold R, Salzman C, Hobson J A. Effects of fluvoxamine and paroxetine on sleep structure in normal subjects: a home-based nightcap evaluation during drug administration and withdrawal.  J Clin Psychiatry.. 2001;  62 642-652
• 14 Sonntag A, Rothe B, Guldner J, Yassouridis A, Holsboer F, Steiger A. Trimipramine and imipramine exert different effects on the sleep EEG and on nocturnal hormone secretion during treatment of major depression.  Depression. 1996;  4 1-13
• 15 Stahl S M, Mendels J, Schwartz G E. Effects of reboxetine on anxiety, agitation, and insomnia: results of a pooled evaluation of randomized clinical trials.  J Clin Psychopharmacology.. 2002;  22 388-392
• 16 Trivedi M H, Rush A J, Armitage R, Gullion C M, Grannemann B D, Orsulak P J, Roffwarg H P. Effects of fluoxetine on the polysomnogram in outpatients with major depression.  Neuropsychopharmacology. 1999;  20 447-459
• 17 van Bemmel A L, Vermeeren M T, Ruigt G, Sennef C. The acute effects of the noradrenaline reuptake inhibitor Org 4428 on EEG sleep in healthy volunteers.  Neuropsychobiology. 1999;  40 107-114
• 18 von Bardeleben U, Steiger A, Gerken A, Holsboer F. Effects of fluoxetine upon pharmacoendocrine and sleep EEG parameters in normal controls.  Int Clin Psychopharmacol. 1989;  4 (suppl 1) 1-5
• 19 Wong E H, Sonders M S, Amara S G, Tinholt P M, Piercey M F, Hoffmann W P, Hyslop D K, Franklin S, Porsolt R D, Bonsignori A, Carfagna N, McArthur R A. Reboxetineoxetine: a pharmacologically potent, selective, and specific norepinephrine reuptake inhibitor.  Biol Psychiatry. 2000;  47 818-829