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Can Lithium Carbonate Prolong the Antidepressant Effect of Sleep Deprivation?

Lewis R. Baxter, Jr, MD
Arch Gen Psychiatry. 1985;42(6):635-635. doi:10.1001/archpsyc.1985.01790290117017
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To the Editor.—  Sleep deprivation produces a prompt, acute antidepressant response in about half of all bipolar and unipolar depressed patients given this treatment.1 The response is shortlived, however, lasting only one or two days in most cases. Sleep deprivation has shown little promise as a clinically useful treatment for depression, though when added to treatment with a tricyclic antidepressant this may result in a somewhat quicker response than with a tricyclic antidepressant alone.2 An initial fortuitous experience with one of our inpatients led me to investigate whether lithium carbonate can sustain the acute antidepressant effect of sleep deprivation, making it clinically useful.

Patients and Methods.—  Twenty-two patients were treated with sleep deprivation and lithium carbonate. Twelve of these patients had an acute antidepressant response. Two patients were deprived of sleep by being kept awake for 38 hours.3 The rest were given partial sleep deprivation, which consists

REFERENCES

Roy-Byrne PP, Uhde TW, Post RM:  Antidepressant effects of one night's sleep deprivation , in Post RM, Ballenger JC (eds): Neurobiology of Mood Disorders . Baltimore, Williams & Wilkins Co, 1984;, pp 817-835.
Elsegna S, van den Hoofkakker RH:  Clinical effects of sleep deprivation and clomipramine in endogenous depression . J Psychiatr Res 1983;;17:361-374.
Gerner RH, Post RM, Gillin JC, Bunney WE:  Biological and behavioral effects of one night's sleep deprivation in depressed patients and normals . J Psychiatr Res 1979;;15:21-40.
Kook KA, Stimmel GL, Wilkins JN, Spangher GG:  Accuracy and safety of a priori lithium loading . J Clin Psychiatry , in press.
Cooper TB, Bergner PE, Simpson GM:  The 24-hour serum lithium level as a prognosticator of dosage requirements . Am J Psychiatry 1973;;130:601-603.
French NH, Heninger GR:  A short clinical rating scale for use by nursing personnel . Arch Gen Psychiatry 1970;;23:233-240.
Hamilton M:  Development of a rating scale for primary depressive illness . Br J Soc Clin Psychol 1967;;6:278-296.
Carroll BJ, Feinberg M, Smouse PE, Rawson SG, Greden JF:  The Carroll rating scale for depression: I. Development, reliability and validation . Br J Psychiatry 1981;;138:194-200.
Doyal LE, Morton WA:  The clinical usefulness of lithium as an antidepressant . Hosp Commun Psychiatry 1984;;35:685-691.

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Roy-Byrne PP, Uhde TW, Post RM:  Antidepressant effects of one night's sleep deprivation , in Post RM, Ballenger JC (eds): Neurobiology of Mood Disorders . Baltimore, Williams & Wilkins Co, 1984;, pp 817-835.
Elsegna S, van den Hoofkakker RH:  Clinical effects of sleep deprivation and clomipramine in endogenous depression . J Psychiatr Res 1983;;17:361-374.
Gerner RH, Post RM, Gillin JC, Bunney WE:  Biological and behavioral effects of one night's sleep deprivation in depressed patients and normals . J Psychiatr Res 1979;;15:21-40.
Kook KA, Stimmel GL, Wilkins JN, Spangher GG:  Accuracy and safety of a priori lithium loading . J Clin Psychiatry , in press.
Cooper TB, Bergner PE, Simpson GM:  The 24-hour serum lithium level as a prognosticator of dosage requirements . Am J Psychiatry 1973;;130:601-603.
French NH, Heninger GR:  A short clinical rating scale for use by nursing personnel . Arch Gen Psychiatry 1970;;23:233-240.
Hamilton M:  Development of a rating scale for primary depressive illness . Br J Soc Clin Psychol 1967;;6:278-296.
Carroll BJ, Feinberg M, Smouse PE, Rawson SG, Greden JF:  The Carroll rating scale for depression: I. Development, reliability and validation . Br J Psychiatry 1981;;138:194-200.
Doyal LE, Morton WA:  The clinical usefulness of lithium as an antidepressant . Hosp Commun Psychiatry 1984;;35:685-691.

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