失眠和耐治疗抑郁症
Wei-Chen Lin1, John Weyl Winkelman2
1Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.
Progress in brain research
|October 8, 2023
概括
抑郁症和睡眠障碍有着强烈的双向联系. 在重大抑郁症 (MDD) 中识别睡眠问题对于治疗至关重要,尤其是新的客观睡眠测量工具.
科学领域:
- 精神病学是一个精神病学.
- 睡眠医学 睡眠医学
- 神经科学是一个神经科学.
背景情况:
- 抑郁症和睡眠障碍有着密切的双向关系.
- 睡眠障碍,特别是失眠,是发展重大抑郁症 (MDD) 的重要危险因素.
- 了解这种联系对于改善治疗耐药抑郁症患者的治疗结果至关重要.
研究的目的:
- 突出睡眠障碍在重大抑郁症 (MDD) 中的关键作用.
- 强调在耐治疗抑郁症中识别隐性睡眠问题的重要性.
- 讨论新的客观睡眠测量工具在临床实践和研究中的潜力.
主要方法:
- 关于抑郁症和睡眠障碍之间的关系的现有文献的综述.
- 讨论MDD的诊断标准,包括睡眠症状.
- 探索新兴技术,以在现实环境中客观地评估睡眠.
主要成果:
- 睡眠障碍是MDD的核心症状和危险因素,具有双向影响.
- 早期识别和治疗失眠可能会预防未来的抑郁情节.
- 客观睡眠测量工具显示出希望,但需要进一步验证才能广泛临床使用.
结论:
- 睡眠和抑郁症之间的相互作用是精神病学和睡眠医学研究的关键领域.
- 准确的表型和睡眠障碍的测量对于促进我们对精神疾病的理解至关重要.
- 整合客观睡眠数据可以彻底改变抑郁症的管理.
相关概念视频
Insomnia
90
Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
Multiple factors contribute...
90
Management of Insomnia
266
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
266
Antidepressant Drugs: MAOIs and Other Agents
260
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
260
Sedatives and Hypnotics Drugs: Miscellaneous Agents
188
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
188
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
418
Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
418
CNS Depressants: Barbiturates and Benzodiazepines
293
CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
293


