Chest
Clinical InvestigationsResponse of Obstructive Sleep Apnea to Fluoxetine and Protriptyline
Section snippets
Subjects
A prospective crossover unblinded trial was used to evaluate the effect of fluoxetine and protriptyline in 12 patients with OSA. All patients were recruited from the MetroHealth Medical Centers Sleep Disorders Clinic. Criteria for inclusion in the study were a history of heavy snoring, daytime hypersomnolence, and documented OSA by polysomnography. Patients were considered for treatment if they had polysomnographic findings of recurrent obstructive apneas in NREM or REM sleep (or both) with
Subject Characteristics
Seven men and five women were studied (Table 1). Six men and three women completed both fluoxetine and protriptyline trials. An additional man and two women completed the fluoxetine trial. The male patient was unable to complete the protriptyline trial because of severe dysuria. One female patient could not continue taking protriptyline because of intolerable “nervousness.” The other woman had to be withdrawn from the study because of the occurrence of an unrelated illness. No patient had
DISCUSSION
This study demonstrates that in the dosage used, neither fluoxetine nor protriptyline was uniformly effective in resolving the sleep-disordered breathing or its consequences of intermittent hypoxemia and interrupted sleep; however, both agents significantly reduced the number of apneas or hypopneas (or both) observed. Fluoxetine was as effective as protriptyline in reducing the number of apneas or hypopneas (or both) and in decreasing apneic time.
Tolerance to fluoxetine was better than that of
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Supported by the Public Health Service and HL-42215 AG-04391.
Manuscript received July 27; revision accepted November 6.