Evidence for REM sleep deprivation as the mechanism of action of antidepressant drugs.

In the treatment of endogenous depression REM sleep deprivation and imipramine have similar efficacy. Across drugs, efficacy of antidepressant activity is directly related to capacity of drugs to produce large and sustained reductions of REM sleep. Endogenous depression unimproved by REM sleep deprivation is unimproved by imipramine. Endogenous depression improvement by REM sleep deprivation and by amitriptyline have the same biological correlate, viz, REM rebound. In animals REM sleep deprivation produces several behavioral changes (e.g., increased motor, sexual, aggressive, pleasure seeking, feeding activities) which are the reverse of behavioral changes of human endogenous depression.