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首页> 外文期刊>International clinical psychopharmacology >Lormetazepam in depressive insomnia: new evidence of phase-response effects of benzodiazepines.
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Lormetazepam in depressive insomnia: new evidence of phase-response effects of benzodiazepines.

机译：洛美西epa在抑郁性失眠中的作用：苯二氮卓类药物的相位响应作用的新证据。

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Benzodiazepines can shift the phase of circadian rhythms in mammalian species, but few data are available on their phase-response effects in humans, and on possible links between timing of administration and hypnotic efficacy. Using a placebo-controlled, cross-over design, we evaluated the hypnotic effect of lormetazepam 0.03 mg/kg and placebo in 38 inpatients who were affected by a major depressive episode. Patients were divided into three groups, receiving treatment at 18.00 h, 20.00 h or 22.00 h, respectively. Sleep and psychiatric symptoms were evaluated with self-administered scales and a sleep diary. The results demonstrate that active treatment significantly improved insomnia independent of the severity of depression, which remained unchanged. Timing of treatment influenced changes in timing of sleep observed with active treatment. Although sleep duration was equally improved in all treatment groups, patients who received treatment at 20.00 h showed an acute advance of sleep onset, with no changes in morning awakening. Patients who received treatment at 22.00 h showed an acute delay in morning awakening, with no changes of sleep onset. Finally, patients who received treatment at 18.00 h showed a non-significant trend in the same direction. These effects reverted with cross-over return to placebo. The perceived degree of improvement of insomnia was proportional to the advance in timing of sleep onset obtained with treatment. Our results suggest that the effects of lormetazepam on the subjective sleep of patients affected by a major depressive episode depend upon the timing of administration, and that improvement in subjective sleep is related to advance of sleep onset, and not to delay of morning awakening.
机译：苯二氮卓类可以改变哺乳动物物种中昼夜节律的相位，但是关于它们在人类中的相位反应作用以及给药时间和催眠功效之间可能的联系的数据很少。使用安慰剂对照的交叉设计，我们评估了氯美西epa 0.03 mg / kg和安慰剂对38例严重抑郁发作患者的催眠作用。将患者分为三组，分别在18.00 h，20.00 h或22.00 h接受治疗。睡眠和精神病症状通过自我量表和睡眠日记进行评估。结果表明，积极治疗可显着改善失眠症，而与抑郁症的严重程度无关，后者保持不变。治疗时间会影响积极治疗中观察到的睡眠时间的变化。尽管所有治疗组的睡眠时间均得到改善，但在20.00 h接受治疗的患者表现出急性的睡眠发作，早晨清醒无变化。在22.00 h接受治疗的患者表现出早晨清醒的严重延迟，而睡眠开始没有变化。最后，在18.00 h接受治疗的患者在相同方向上没有显着趋势。这些效应可通过交叉转换回到安慰剂。感觉到的失眠改善程度与通过治疗获得的睡眠开始时间的提前成正比。我们的研究结果表明，氯吡西on对受重度抑郁发作影响的患者的主观睡眠的影响取决于给药的时机，主观睡眠的改善与睡眠发作的进展有关，而与延迟清晨没有关系。

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