Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Smith, G. S. Articles by Kupfer, D. J. Search for Related Content PubMed Citation Articles by Smith, G. S. Articles by Kupfer, D. J. Geriatric Psychiatry Depression Antidepressants Other Somatic Therapy PET

Cerebral Glucose Metabolic Response to Combined Total Sleep Deprivation and Antidepressant Treatment in Geriatric Depression

OBJECTIVE: The treatment of geriatric depression is complicated by a variable and delayed response to antidepressant treatment. The present study was undertaken to test the hypothesis that combined total sleep deprivation and paroxetine treatment would produce a persistent reduction in glucose metabolism in the anterior cingulate cortex similar to that reported after long-term antidepressant treatment. METHOD: Six elderly depressed patients who met the DSM-IV criteria for major depressive disorder and six age-matched comparison subjects underwent serial positron emission tomography (PET) studies at baseline, after total sleep deprivation, after recovery sleep (after the initial paroxetine dose), and after 2 weeks of paroxetine treatment (patients only). The PET data were analyzed by using statistical parametric mapping methods. RESULTS: The patients' scores on a 13-item version of the Hamilton Depression Rating Scale were decreased after total sleep deprivation, after recovery sleep, and after 2 weeks of treatment. The Hamilton depression scores of the comparison subjects were not significantly altered. In the patients, the greatest reductions in normalized, relative glucose metabolism after sleep deprivation were observed in the anterior cingulate cortex (Brodmann area 24), and they persisted after recovery sleep and antidepressant treatment. The comparison subjects demonstrated increased metabolism in these areas. CONCLUSIONS: Improvement in the patients' depressive symptoms was accompanied by reduced glucose metabolism in the right anterior cingulate cortex and right medial frontal cortex. These preliminary data indicate that in elderly depressed patients, total sleep deprivation may accelerate the clinical and glucose metabolic response to antidepressant treatment.

This article has been cited by other articles:

				C. Andreescu, B. H. Mulsant, P. R. Houck, E. M. Whyte, S. Mazumdar, A. Y. Dombrovski, B. G. Pollock, and C. F. Reynolds III Empirically Derived Decision Trees for the Treatment of Late-Life Depression Am J Psychiatry, July 1, 2008; 165(7): 855 - 862. [Abstract] [Full Text] [PDF]

				G. S. Alexopoulos, C. F. Murphy, F. M. Gunning-Dixon, V. Latoussakis, D. Kanellopoulos, S. Klimstra, K. O. Lim, and M. J. Hoptman Microstructural White Matter Abnormalities and Remission of Geriatric Depression Am J Psychiatry, February 1, 2008; 165(2): 238 - 244. [Abstract] [Full Text] [PDF]

				H. Takami, Y. Okamoto, H. Yamashita, G. Okada, and S. Yamawaki Attenuated Anterior Cingulate Activation During a Verbal Fluency Task in Elderly Patients With a History of Multiple-Episode Depression Am J Geriatr Psychiatry, July 1, 2007; 15(7): 594 - 603. [Abstract] [Full Text] [PDF]

				M. A. Butters, R. K. Bhalla, B. H. Mulsant, S. Mazumdar, P. R. Houck, A. E. Begley, M. A. Dew, B. G. Pollock, R. D. Nebes, J. T. Becker, et al. Executive Functioning, Illness Course, and Relapse/Recurrence in Continuation and Maintenance Treatment of Late-Life Depression: Is There a Relationship? Am J Geriatr Psychiatry, August 1, 2004; 12(4): 387 - 394. [Abstract] [Full Text] [PDF]

				G. S. Alexopoulos Frontostriatal and Limbic Dysfunction in Late-Life Depression Am J Geriatr Psychiatry, December 1, 2002; 10(6): 687 - 695. [Abstract] [Full Text] [PDF]

				G. S. Smith, E. Kramer, C. R. Hermann, S. Goldberg, Y. Ma, V. Dhawan, A. Barnes, T. Chaly, A. Belakhleff, F. Laghrissi-Thode, et al. Acute and Chronic Effects of Citalopram on Cerebral Glucose Metabolism in Geriatric Depression Am J Geriatr Psychiatry, December 1, 2002; 10(6): 715 - 723. [Abstract] [Full Text] [PDF]

				G. S. Smith, C. F. Reynolds III, P. R. Houck, M. A. Dew, Y. Ma, B. H. Mulsant, and B. G. Pollock Glucose Metabolic Response to Total Sleep Deprivation, Recovery Sleep, and Acute Antidepressant Treatment as Functional Neuroanatomic Correlates of Treatment Outcome in Geriatric Depression Am J Geriatr Psychiatry, October 1, 2002; 10(5): 561 - 567. [Abstract] [Full Text] [PDF]

				H. S. Mayberg, J. A. Silva, S. K. Brannan, J. L. Tekell, R. K. Mahurin, S. McGinnis, and P. A. Jerabek The Functional Neuroanatomy of the Placebo Effect Am J Psychiatry, May 1, 2002; 159(5): 728 - 737. [Abstract] [Full Text] [PDF]

				D. Pizzagalli, R. D. Pascual-Marqui, J. B. Nitschke, T. R. Oakes, C. L. Larson, H. C. Abercrombie, S. M. Schaefer, J. V. Koger, R. M. Benca, and R. J. Davidson Anterior Cingulate Activity as a Predictor of Degree of Treatment Response in Major Depression: Evidence From Brain Electrical Tomography Analysis Am J Psychiatry, March 1, 2001; 158(3): 405 - 415. [Abstract] [Full Text]

				C. C. Meltzer Neuropharmacology and Receptor Studies in the Elderly J Geriatr Psychiatry Neurol, October 1, 1999; 12(3): 137 - 149. [Abstract] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 1999 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us