25 September 2017

Minus by minus = doubtful plus

Treating depression with insomnia: benefit or harm?

Anna Kerman, XX2 century

Does depression prevent you from sleeping at night? It can improve your mood, according to a new study. Scientists from the Perelman School of Medicine at the University of Pennsylvania studied the results of a number of studies on sleep deprivation and came to an unexpected conclusion. It turns out that lack of sleep can temporarily alleviate the symptoms of depression in almost half of patients.

An analysis of 66 English-language studies conducted between 1974 and 2016 showed that both partial (20-21 hours without sleep) and complete (up to 36 hours without sleep) deprivation can be called an effective antidepressant. At the same time, the effectiveness of treatment, as it turned out, did not depend on the patient's age, gender, or other socio-demographic characteristics. It did not affect the effect of what exactly was being done to disrupt sleep.

The new work is published in the Journal of Clinical Psychiatry. Its authors noted that it is possible to determine why a lack of sleep relieves the symptoms of depression so quickly only with the help of additional research.

"More than 30 years have passed since the antidepressant effect of sleep deprivation was discovered. However, we still do not have a ready answer to the question of how effective such treatment is and how to achieve the best results," says associate professor of psychiatry, lead author of the study Philip German (Philip Gehrman).

One of the 2015 studies (work published in the journal Neuron) demonstrated that sleep deprivation affects the same receptor as tricyclic antidepressants and ketamine. And the fact that sleep deficiency can improve mood was discovered about 200 years ago. Since then, sleep deprivation has been used periodically in medicine – with varying success.

So, in the 1970s, the so-called wake therapy was developed, which was sometimes prescribed to patients at the start of treatment for depression. However, the effect of this approach did not last long: patients reported the return of symptoms within a few days (maximum – a week) after the procedure.

And today sleep deprivation is sometimes used in the treatment of depression. But, as some experts note, a lack of adequate sleep in itself can be considered as a risk factor for the development of mental illness. And even if sleep deprivation is used to temporarily relieve symptoms of depression, it should not be the only treatment. Patients should also change their habits, take medications and use other methods of treating depression with proven effectiveness.

Dr. Nina Urban, associate professor of psychiatry at New York University, argues that doctors do not have strong enough evidence that sleep deprivation in the long term is a safe and effective method of combating depression. On the contrary, it can harm patients.

"Chronic sleep deficiency has a bad effect on the immune and cardiovascular systems, thereby increasing the risk of developing other diseases," says Dr. Urban. – We have too few studies on long-term sleep deprivation in depression. Therefore, it is difficult to say at what point the antidepressant effect of chronic lack of sleep will no longer outweigh other health risks."

Portal "Eternal youth" http://vechnayamolodost.ru  25.09.2017

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