Antidepressants for sleep problems

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Antidepressants for sleep problems

Antidepressant medications are often prescribed for people with insomnia. Best results are seen in people who have underlying depression.¹ Although they have not been well studied for insomnia, doctors often prescribe low doses of certain antidepressants in an attempt to facilitate sleep.

Examples of the antidepressants that might be prescribed for insomnia are amitriptyline (such as Elavil) and trazodone (Desyrel).

The other side effects of these medications, which may include sexual dysfunction, weight gain, dry mouth and throat, racing pulse, confusion, and disturbed dreams, must be weighed against their potential benefits.^{2, 3}

FDA Advisories. The US Food and Drug Administration (FDA) has issued:

FDA Advisory.

• A warning on the antidepressants Paxil and Paxil CR (paroxetine) and birth defects. One new study showed that women who took Paxil during their first 12 weeks of pregnancy had a slightly higher chance of having a baby with birth defects.
• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.

References

Citations

1. Working Group on Insomnia, National Heart, Lung, and Blood Institute (1999). Insomnia: Assessment and management in primary care. American Family Physician, 59(11): 3029–3038.

2. Kupfer DJ, Reynolds CF III (1997). Management of insomnia. New England Journal of Medicine, 336(5): 341–346.

3. Bursztajn HJ (1999). Melatonin therapy: From benzodiazepine-dependent insomnia to authenticity and autonomy. Archives of Internal Medicine, 159(20): 2393–2395.

Credits

Last updated:	February 02, 2006
Author:	Merrill Hayden
Reviewed By:	Kathleen Romito, MD - Family Medicine, Malin K. Clark, MD, FRCPC - Psychiatry
Editors:	Susan Van Houten, RN, BSN, MBA, Michele Cronen