Risperidone Augmentation Decreases Rapid Eye Movement Sleep and Decreases Wake in Treatment-Resistant Depressed Patients
J Clin Psychiatry 2003;64:192-196
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The atypical antipsychotic agent
risperidone has beneficial effects on mood in patients with
schizophrenia. This study aimed to assess whether risperidone
produced typical antidepressant-like effects in the polysomnogram
of healthy subjects and in depressed patients unresponsive to
Method: We measured the effect of a
single dose of risperidone (1 mg) on the polysomnogram of 8
healthy volunteers in a placebo-controlled, double-blind,
crossover design. We also measured the effects of open-label
risperidone treatment (0.5-1.0 mg daily) on the polysomnogram of
8 patients meeting DSM-IV criteria for major depressive disorder
who had received therapeutic doses of an antidepressant with an
unsatisfactory response. Sleep was recorded at baseline and
following 2 weeks of risperidone addition.
Results: In the healthy volunteers, risperidone
significantly decreased rapid eye movement (REM) sleep (p = .04).
After 2 weeks of risperidone treatment, depressed patients had
significantly less wake (p = .02) and REM sleep (p = .02). Scores
on depression rating scales for the depressed patients showed a
significant decline (p < .05).
Conclusion: Risperidone administration decreases
REM sleep in both healthy volunteers and medication-resistant
depressed patients, an action characteristic of conventional
antidepressant medication. In depressed patients, risperidone
also decreased wake. The utility of risperidone as an
augmentation agent in depressed patients merits controlled study.