Trimipramine: acute and lasting effects on sleep in healthy and major depressive subjects.

The acute effects of trimipramine on sleep EEG patterns were investigated in six depressed inpatients and six healthy volunteers. The effects of long-term administration were then assessed in depressed patients after 4 weeks of treatment. Sedative effects of the drug were more pronounced in healthy subjects while sleep parameters of depressed patients seemed less sensitive to the drug. Chronic effects tended to correct most of the sleep disturbances seen in depressed subjects with respect to the natural organization of sleep. The major sleep effect of trimipramine concerned REM latency which was lengthened in both groups, independently of the treatment protocol.

Antidepressant effect of 5-methoxypsoralen: The melatonin synchronizer hypothesis.

5-methoxypsoralen (5-MOP) stimulates pineal melatonin secretion, and a decrease in dark phase melatonin levels has been described in major depression. As exogenous melatonin has shown synchronizer properties, authors hypothesized that giving 5-MOP would have antidepressant properties. Twenty-six inpatients meeting the criteria of major depressive disorders were enrolled in a four-week, double blind trial of 5-MOP versus amitriptyline. Clinical improvement was identical in both treatment groups but biological changes were different in each group: 5-MOP patients showed an early nocturnal surge of melatonin levels that was maintained at the fourth treatment week, while melatonin levels remained unchanged in patients treated with amitriptyline.

[Plasma tryptophan in a protein controlled diet in depressed patients]. / Tryptophane plasmatique à apport protéique contrôlé chez des déprimés.

Cerebral serotonin is synthetized from its blood precursor: tryptophan (TRP), an essential amino acid (6). TRP has been extensively studied since serotonine has been reported to be involved in the pathogenesis of depression (9). In one hand, brain serotonin content depends on regulation by plasma large neutral amino acids (LNAA): leucine, isoleucine, valine, tyrosine and phenylalanine that compete with TRP to cross over the blood brain barrier (7, 13). In the other hand TRP is largely linked with albumin. So, we have studied plasma total TRP, free TRP and the ratio TRP on LNAA as potential cerebral serotonin index. The aim of this study is to observe the blood variations of the biological parameters in fasting and postprandial conditions in 8 depressed women, aged from 57 to 78 years, on a short protein controlled diet: 4 women had TRP poor then rich diet and the others 4 rich then poor. Alimentary proteins modulated diets and each patient was his own control: the results under modulated diet were compared with those under normal diet at the same time. More over, 2 psychotic patients aged 58 and 70 years have been studied at the same time, in each group. Biological datas were compared with clinical evolution.

[Disorders of circadian rhythms in depression]. / Les troubles des rythmes circadiens dans la dépression.

The authors make a synthesis of studies about circadian rhythms in depression and of hypothesis to explain them. They successively study trials on the phases, on the average levels, on the amplitude of rhythms. They conclude the most significant troubles are, shortening of latency on paradoxical sleep for phases, slump of melatonin levels, blunded amplitude of every parameter. Among possible explanations, they present and discuss a trouble of oscillators, a decrease of sensitivity to external synchronizers and a trouble in rhythm coupling.