[Antidepressant therapy by sleep deprivation (author's transl)].
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Biomedical subjects
Publications and source records attributed to G A Rudolf.
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Sleep deprivation (SD) has been proved to be an effective measure of antidepressive treatment (especially in endogenous depression). In a new study, 125 SD were examined on 93 depressed patients. The therapeutic benefit of SD on endogenous depression consists not only of the nightly clear up but also of provoking or improving a typical day wave the day after DS. A period of at least 36 h is necessary to survey the total effect of this method. The best results are achieved in patients with severe endogenous depression, especially in those with the typical day wave and distinct somatic symptoms. The effect of partial SD (for the second half of the night) is almost the same as that of total SD. The advantages of partial SD are: the patient can stand it easier, more often, and - in the company of a suited person - even at home. Finally, it is less complicate in clinical routine than selective REM-deprivation.
The effect of sleep deprivation (SD) on the altered circadian rhythm of endogenous-depressed patients has been investigated. 61 patients (39 endogenous- and 22 neurotic-depressed) with normal cardio-circulatory activities were tested: During SD-night pulse rate is less lowered in endogenous than in neurotic depression. The increase of systolic blood pressure is quicker and higher in endogenous than in neurotic depression. - Surveying the patients for 72 h (before, during and after SD), pulse rate in endogenous- and neurotic-depressed is less markedly fluctuating than in normal individuals. There is a close connection between the circadian fluctuationsof the depressive symptoms and of the pulse rates. The more SD improves depressive symptoms the more it also flattens the wave of pulse rates. - The circadian courses of systolic blood pressure in endogenous- and neurotic-depressed and in normal subjects are nearly the same. SD markedly flattens the circadian rhythm of blood pressure. In neurotic depression, SD does not clearly alter the course of pulse and blood pressure rates.
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Cerebral arteriosclerosis is a frequent, often not sufficiently diagnosed disease in the second half of the life span. Possible causes, diagnosis, and therapy are explicitly shown of its somatic and psycho-pathological symptoms, often acute, and chronically persistent. Particular emphasis is put on acute-care and the therapeutic relevance of socio-and psychotherapy. Finally, consequences for forensic medical opinions are shown.