Imipramine effects on sleep in depressed adolescents: a preliminary report.

Antidepressant medications, including ~cyclic antidepressants, monoamine oxidase inhibitors, lithium, and fluoxetine, generally have been found to suppress rapid eye movement (RFaM) sleep (yon Bardeleben et al. 1989, reviewed by Salem 1986), although several unusual antidepress~ts have been found to increase REM sleep (Wiegand et al. 1986; Di Peril et al. 1987; Soldatos et al. 1988; Monti 1989). Additional evidence that there may be a_n association between the antidepressant effects of the medications and their REM sleep effects include the following: (1)The extent to which amitrip~!ine (Kupfer et ai. 1976; Gillin et al. 1978; Kupfer et al. 1981) and clomipramine (H6chli et at: 1986) suppress REM sleep was found to ~redict eventual antidepressant response in depressed adults. Kupfer et al. (1979) extended these findings into depressed ctfildren ,'xeated with hnipmmine. (2) Selective REM sleep deprivation improved depressive symptoms (Vogel et al. 1975). Eight of 9 subjects unrespeusive to selec~ve REM sleep depfivafian were also unre%-~onsive to imi_pramine. Characteristic sleep abnormalities found in depressed adults have not been consistently