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Michael E. DeBakey VA Medical Center - Houston, Texas

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Study Examines 2 Types of Treatment Plans for People Suffering from Depression and Insomnia

August 8, 2006

HOUSTON - The Michael E. DeBakey VA Medical Center (MEDVAMC) is conducting a clinical research study comparing the feasibility and effectiveness of two treatment approaches for individuals with insomnia and a history of major depression or bipolar disorder. The study focuses on both veterans and non-veterans, over the age of 60 who have difficulty starting or initiating sleep four or more times a week for at least three months and who meet study eligibility criteria.

Major depression is when five or more symptoms of depression are present for at least two weeks. These symptoms include feeling sad, hopeless, worthless, or pessimistic. In addition, people with major depression often have behavior changes, such as new eating and sleeping patterns. Bipolar disorder, also known as manic-depressive illness, is a brain disorder causing unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe.

"Sleep disturbances and depression tend to go hand in hand. Troubled sleep is considered a hallmark of the mood disorder. At least 80 percent of depressed people experience insomnia, that is a difficulty falling asleep or, most often, staying asleep," said Rayan Al Jurdi, M.D., MEDVAMC psychiatrist and director of the MEDVAMC Mood Disorders Clinic.

The two treatment approaches being examined in this study are Cognitive-Behavioral Therapy and the quetiapine medication therapy. CBT is a treatment focusing on patterns of thinking that are maladaptive and the beliefs that underlie such thinking. For example, a person who is depressed may have the belief, "I’m worthless," and a person with a phobia may have the belief, "I am in danger." While the person in distress likely holds such beliefs with great conviction, with a therapist’s help, the individual is encouraged to view such beliefs as hypotheses rather than facts and to test out such beliefs by running experiments. Furthermore, those in distress are encouraged to monitor and log thoughts that pop into their minds in order to enable them to determine what patterns of biases in thinking may exist and to develop more adaptive alternatives to their thoughts. The other treatment option being examined in this study is the use of quetiapine, an antipsychotic medication that works by changing the actions of chemicals in the brain.

“With this study, we hope to establish safe guidelines in the treatment of insomnia among elderly patients,” said Al Jurdi.

This research study has been approved by the Baylor College of Medicine Investigative Review Board. Participants will be compensated for their time and travel. For a free, confidential screening or more information, call the MEDVAMC at (713) 791-1414, ext. 2247 or (713) 794-8709.

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