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State or Trait Marker of Depression?

Mathias Berger, MD; Dieter Riemann, Dipl Psych; Dominique Höchli, MD; René Spiegel, PhD

Arch Gen Psychiatry. 1989;46(5):421-428.

Abstract
• Rapid eye movement (REM) sleep disinhibition at the beginning of the night is one of the most frequently described biologic abnormalities in depression. As REM sleep in animals and humans seems to be facilitated by cholinergic neuronal activity, it has been postulated that REM sleep disinhibition in depression is a consequence of cholinergic neuronal overactivity. The current study with the newly available cholinergic agonist RS-86, which is orally active, has a half-life of six to eight hours, and exhibits only minor peripheral side effects, supports this assumption. The application of this compound before sleep led to a significantly faster induction of REM sleep at the beginning of the night in patients with major depressive disorders compared with healthy subjects and patients with other nondepressive psychiatric diseases, such as eating disorders. Whereas 14 of 16 depressed patients displayed sleep-onset REM periods after the administration of RS-86, this happened only in three of the 16 healthy controls and in one of the 20 patients with other diagnoses. The increased susceptibility of REM sleep to cholinergic stimulation was limited to the state of depression and was not observed in a group of remitted depressed patients.

Author Affiliations
From the Max Planck Institute for Psychiatry, Munich. Dr Berger and Mr Riemann are now with the Central Institute of Mental Health, Mannheim, Federal Republic of Germany, and Dr Spiegel is now with the University of Basel (Switzerland) and Sandoz AG, Clinical Research, Basel.

Footnotes
Accepted for publication March 10, 1988.

Reprint requests to Central Institute of Mental Health, J 5, POB 5970, 6800 Mannheim, Federal Republic of Germany (Dr Berger).

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