[Polygraphic, clinical and therapeutic markers of dopamine-dependent depressions]

Among patients referred for areactive depression who were polygraphically recorded after at least 2 weeks without any pharmacological treatment, some were found to present qualitative sleep symptoms similar to those already described in clinically diagnosed parkinsonian patients. A therapeutic trail with a dopamine agonist (Piribedil) was followed, in all of these patients, by a dramatic and rapid improvement of mood. As compared to areactive depressive patients whose sleep recordings were free of these qualitative abnormalities, some quantitative sleep criteria, mainly related to REM sleep, permit to diagnose this group of dopamine dependent depression (DDD). These data, together with the beneficial effect of Piribedil, favor a role of DA in the genesis of this type of depression. Some clinical signs now appear as sufficient to diagnose these DDD. The interest of this study is that all the patients (now 48), among whom no clinical parkinsonian symptoms were found, diagnosed according to the reported polygraphic criteria were cured following this treatment.