Abstract
The aim of this review was to describe the sleep anomalies in depression, the effects of antidepressants on sleep, the usefulnessof antidepressants in the treatment of primary insomnia and insomnia in other psychiatric disorders.
Depression is associated with abnormalities in the sleep pattern that include disturbances of sleep continuity, diminished slow-wave sleep(SWS) and altered rapid eye movement (REM) sleep parameters. Although none of the reported changes in sleep are specific to depression,many of them, for example increased REM density and reduced amount of SWS in the first sleep cycle, are used as biologicalmarkers for research on depression and in the development of antidepressant drugs.
An antidepressant should reverse abnormalities in the sleep pattern. However, many antidepressants can worsen sleep. Because of the activatingeffects of some drugs, for example imipramine, desipramine, fluoxetine, paroxetine, venlafaxine, reboxetine and bupropion,many patients who take them have to be co-prescribed with sleep-promoting agents to improve sleep. Even in maintenance treatmentwith activating antidepressants as many as 30-40% of patients may still suffer from insomnia. Antidepressants with sleep-promoting effectsinclude sedative antidepressants, for example doxepin, mirtazapine, trazodone, trimipramine, and agomelatine which promotes sleepnot through a sedative action but through resynchronization of the circadian rhythm. Sedative antidepressants are frequently used in thetreatment of primary insomnia, although not many double-blind studies have been provided to support such an approach to insomniatreatment. One exception is doxepin, which has been approved for the treatment of insomnia characterized by difficulties in maintainingsleep.
Keywords:Sleep, depression, antidepressants, effects on sleep, primary insomnia.
Current Pharmaceutical Design
Title:Sleep and Antidepressant Treatment
Volume: 18Issue: 36
Author(s):Adam Wichniak, Aleksandra Wierzbicka and Wojciech Jernajczyk
Affiliation:
Keywords:Sleep, depression, antidepressants, effects on sleep, primary insomnia.
Abstract: The aim of this review was to describe the sleep anomalies in depression, the effects of antidepressants on sleep, the usefulnessof antidepressants in the treatment of primary insomnia and insomnia in other psychiatric disorders.
Depression is associated with abnormalities in the sleep pattern that include disturbances of sleep continuity, diminished slow-wave sleep(SWS) and altered rapid eye movement (REM) sleep parameters. Although none of the reported changes in sleep are specific to depression,many of them, for example increased REM density and reduced amount of SWS in the first sleep cycle, are used as biologicalmarkers for research on depression and in the development of antidepressant drugs.
An antidepressant should reverse abnormalities in the sleep pattern. However, many antidepressants can worsen sleep. Because of the activatingeffects of some drugs, for example imipramine, desipramine, fluoxetine, paroxetine, venlafaxine, reboxetine and bupropion,many patients who take them have to be co-prescribed with sleep-promoting agents to improve sleep. Even in maintenance treatmentwith activating antidepressants as many as 30-40% of patients may still suffer from insomnia. Antidepressants with sleep-promoting effectsinclude sedative antidepressants, for example doxepin, mirtazapine, trazodone, trimipramine, and agomelatine which promotes sleepnot through a sedative action but through resynchronization of the circadian rhythm. Sedative antidepressants are frequently used in thetreatment of primary insomnia, although not many double-blind studies have been provided to support such an approach to insomniatreatment. One exception is doxepin, which has been approved for the treatment of insomnia characterized by difficulties in maintainingsleep.
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Cite this article as:
Wichniak Adam, Wierzbicka Aleksandra and Jernajczyk Wojciech, Sleep and Antidepressant Treatment, Current Pharmaceutical Design 2012; 18 (36) .https://dx.doi.org/10.2174/138161212803523608
| DOI https://dx.doi.org/10.2174/138161212803523608 | Print ISSN 1381-6128 |
| Publisher Name Bentham Science Publisher | Online ISSN 1873-4286 |
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