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Robert M. Post, MD; Joel Kotin, MD; Frederick K. Goodwin, MD

Arch Gen Psychiatry. 1976;33(5):627-632.

Abstract
• Nineteen patients, each hospitalized with a major depressive episode, were deprived of sleep for one night. Ten patients responded with clear improvement in depressive symptoms; the substantial clinical change was transient, usually lasting one day. Those who responded had significantly higher initial depression ratings (P <.01) and tended to be older than nonresponders who experienced mild increases in irritability, fatigue, and discomfort following sleep deprivation. Amine metabolites, 5-hydroxyindoleacetic acid (5HIAA), and homovanillic acid (HVA) were not substantially affected by sleep deprivation, although there was a significant interaction of clinical response and direction of 3-methoxy-4-hydroxyphenylglycol (MHPG) change. Sleep deprivation thus produces acute, but only transient improvement in a selected group of severely depressed patients; it appears to be an important tool in the study of the affective disorders.

Author Affiliations
From the sections on psychobiology (Dr Post) and psychiatry (Dr Goodwin), National Institute of Mental Health, Bethesda, Md, and the Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine (Dr Kotin).

Footnotes
Accepted for publication Dec 15, 1975.

Reprint requests to 3-West Clinical Research Unit, Section on Psychobiology, Adult Psychiatry Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, MD 20014 (Dr Post).

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