REM Sleep Latency in Major Depressed Patients Predicts Mood Improvement After Transdermal Nicotine Administration

C mechanisms underlying (Rapid Eye Movement) REM sleep have been supported through different studies (1). In major depression, a hypersensitivity of the cholinergic system has been proposed (2). Cholinergic challenges have been used as a test for hypersensitivity of the cholinergic system in depressed patients and in the first degree relatives, looking for changes in sleep variables (3). Glassman et al (4), have reported a high frequency of cigarette smoking among individuals who have experienced major depression, while smokers with major depression have been less successful than non depressed smokers in their attempts to quit smoking (5). Recently it has been shown that a subgroup of subjects during smokingcessation treatment developed major depression disorder although some of them were on fluoxetine 30 mg/day (6). Transdermal nicotine has been used in normal volunteers in order to evaluate its effects on sleep. A doseresponse curve with two doses of nicotine (7 and 14 mg) and placebo patches were studied. The main changes were reduction in both total sleep and REM sleep times (7). Nicotine transdermal patches were studied in a comparative study between normal volunteers and major depressed patients (8). Normal volunteers reduced both total sleep time as well as REM sleep, as previously reported, but depressed patients showed an increase in total sleep time and REM sleep time. Depressed patients also showed a short-lasting improvement in mood. Antidepressant effect of four days administration of nicotine patches was also reported in 10 major depressed patients. After the second day of nicotine administration, a significant reduction of Hamilton Depression Scale (HAMD) was observed. Patients relapsed after 2 to 4 days of the last nicotine path (9). In a sleep study with 6 major depressed patients and 6 normal volunteers with four continuos nights of transdermal nicotine administration, it REM Sleep Latency in Major Depressed Patients Predicts Mood Improvement After Transdermal Nicotine Administration