EFFICACY OF PAROXETINE AND MIRTAZAPINE ON SLEEP IN
PATIENTS WITH DEPRESSION AND THEIR RELATIONSHIP WITH
POLYSOMNOGRAPHY
YUNSHU ZHANG 1, LILI ZHANG 2, HEMIN SHI 1, JIANHUA SUN 1, SHUHUI GAO 1, KEQING LI 2*
1Sleep Medicine Department, Hebei Province Sixth People’s Hospital, Baoding City, Hebei Province, 071000, China
2Mental Health Institute, Hebei Province Sixth People’s Hospital, Baoding City, Hebei Province, 071000, China
*corresponding author: keqingli572@163.com
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Abstract:
This study aimed to investigate the effect of paroxetine and mirtazapine on polysomnography (PSG) and sleep quality in patients
with depression, and to explore the changes in PSG scores after the antidepressant treatment. Patients were divided into two groups:
paroxetine group (P group) and mirtazapine group (M group). The PSG scores and sleep quality were compared before and six
weeks after the antidepressant treatment. The severity of depression was assessed by the Hamilton Rating Scale for Depression
(HAMD). Patients sleep quality was assessed by HAMD sleep disorder score and Pittsburgh Sleep Quality Index (PSQI). The efficacy
of the antidepressant treatment was assessed by HAMD score reduction percentage. Abnormalities during sleep, sleep structure
and rapid eye movement (REM) sleep indicators were observed in the depressed patients compared to the control group. The effect
of antidepressant medication in P group included: the number of awakening and sleepiness increased, the sleep efficiency
decreased, the preponderance of Stage1 (S1) increased, REM sleep time and percentage decreased, REM sleep latency and
REM activity and intensity decreased (p < 0.05). Assessment of depression medication in M group showed: the sleep latency
shortened; the number of awakening and sleepiness episodes decreased; the sleep efficiency increased; and the percentage of
S1 decreased. In this group, the REM sleep was not statistically significantly changed. The scores of HAMD and PSQI in P
group and M group were statistically significantly lower than those before the antidepressant treatment (p < 0.05). There were no
statistically significant differences in HAMD and PSQI scores between group P and M after the treatment of depression (p > 0.05).
HAMD reduction percentage and PSG score were not statistically significant correlated (p > 0.05). At the end of the trial, patients
with HAMD scores reduced by 50% were labelled as responders; those with less than 50% were labelled as non-responders.
The Delta sleep in the non-responders group was statistically lower compared to the responders group.

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