Posted by djmmm on March 4, 2002, at 15:34:31
In reply to Re: MAOIs and sleep problems, posted by mdmicky on March 2, 2002, at 14:59:03
Here's some info on MAOIs and sleep problems...
from
http://www.cogsci.soton.ac.uk/bbs/Archive/bbs.vertes.html
Monoamine oxidase inhibitors (MAOIs)
Of the antidepressants, the MAOIs have the strongest suppressive action on REM sleep. A number of early reports using normal and patient populations showed that MAOIs virtually completely (or completely) suppressed REM sleep for weeks to several months. In an initial study, Wyatt et al. (1969) reported that the MAOIs, isocarboxazid, pargyline hydrochloride, and mebanazine, reduced REM from about 20-25% of TST to 9.7%, 8.6% and 0.4% of TST, respectively, and that in one subject REM was virtually eliminated for two weeks.
In a subsequent report in anxious-depressed patients, Wyatt and co-workers (1971a) described the remarkable findings that the MAOI, phenelzine (Nardil), given at therapeutic doses, completely abolished REM sleep in six patients for periods of 14 to 40 days. There was a gradual decline in amounts of REM sleep for the first two weeks on the drug and a total loss of REM after 3-4 weeks. In a complementary study with narcoleptic patients, Wyatt et al. (1971b) reported that phenelzine completely abolished REM in 5 of 7 patients for the following lengths of time: 14, 19, 93, 102 and 226 days. They stated that: "The complete drug-induced suppression of REM sleep in these patients is longer and more profound than any previously described"; and further that "No adverse psychological effects were noted during the period of total rapid-eye-movement suppression".
Several other studies have similarly shown that MAOIs essentially abolish REM sleep. Akindele et al. (1970) reported that phenelzine completely eliminated REM sleep in four subjects (one normal and 3 depressed) for 2 to 8 weeks, and addressing possible behavioral consequences stated that "Far from this leading to disastrous effects on mental functions, as some might have proposed, clinical improvement began". Kupfer and Bowers (1972) showed that phenelzine abolished REM in 7 of 9 patients, and drastically suppressed it in remaining patients from pre-drug values of 23.1% and 24.8% of TST to 1.4% and 0.5% of TST, respectively. Finally, Dunleavy and Oswald (1973) reported that phenelzine eliminated REM in 22 depressed patients.
If REM sleep were involved in memory consolidation, it would seem that the total loss of REM with MAOIs for periods of several months to a year (Wyatt et al. 1969, 1971a, 1971b; Kupfer & Bowers 1972; Dunleavy & Oswald 1973) would affect memory. As indicated above, the loss of REM did not appear to be associated with any noticeable decline in cognitive functions in these largely patient populations. These studies, however, made no systematic attempt to assess the effects of MAOIs on cognition.
Other reports, however, have examined the actions of MAOIs, primarily phenelzine, on cognition/memory and described an essential lack of impairment (Rothman et al. 1962; Raskin et al. 1983; Georgotas et al. 1983, 1989). For example, Raskin et al. (1983) observed no adverse effects of phenelzine on a battery of 13 psychomotor and cognitive tasks in a heterogeneous population of 29 depressed patients. Similarly, Georgotas and colleagues (Georgotas et al. 1983, 1989) reported that elderly depressed patients given phenelzine for 2 to 7 weeks showed no alteration in several measures of cognitive function, and concluded that the lack of adverse effects with phenelzine suggests that it is preferable to TCAs (see below) in the treatment of depression in the geriatric population.
poster:djmmm
thread:73594
URL: http://www.dr-bob.org/babble/20020301/msgs/96353.html