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Antidepressants and their effect on sleep

Antidepressants and their effect on sleep
Antidepressants and their effect on sleep
Given the relationship between sleep and depression, there is inevitably going to be an effect of antidepressants on sleep. Current evidence suggests that this effect depends on the class of antidepressant used and the dosage. The extent of variation between the effects of antidepressants and sleep may relate to their mechanism of action. This systematic review examines randomised-controlled trials (RCTs) that have reported the effect that antidepressants appear to have on sleep. RCTs are not restricted to depressed populations, since several studies provide useful information about the effects on sleep in other groups. Nevertheless, the distinction is made between those studies because the participant's health may influence the baseline sleep profiles and the effect of the antidepressant. Insomnia is often seen with monoamine oxidase inhibitors (MAOIs), with all tricyclic antidepressants (TCAs) except amitriptyline, and all selective serotonin reuptake inhibitors (SSRIs) with venlafaxine and moclobemide as well. Sedation has been reported with all TCAs except desipramine, with mirtazapine and nefazodone, the TCA-related maprotiline, trazodone and mianserin, and with all MAOIs. REM sleep suppression has been observed with all TCAs except trimipramine, but especially clomipramine, with all MAOIs and SSRIs and with venlafaxine, trazodone and bupropion. However, the effect on sleep varies between compounds within antidepressant classes, differences relating to the amount of sedative or alerting (insomnia) effects, changes to baseline sleep parameters, differences relating to REM sleep, and the degree of sleep-related side effects.
antidepressants, sleep, review, randomised-controlled trials
0885-6222
533-559
Mayers, Andrew G.
c1700d3a-ccbf-48ad-8777-c5e9336dbdc0
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Mayers, Andrew G.
c1700d3a-ccbf-48ad-8777-c5e9336dbdc0
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e

Mayers, Andrew G. and Baldwin, David S. (2005) Antidepressants and their effect on sleep. Human Psychopharmacology: Clinical and Experimental, 20 (8), 533-559. (doi:10.1002/hup.726).

Record type: Article

Abstract

Given the relationship between sleep and depression, there is inevitably going to be an effect of antidepressants on sleep. Current evidence suggests that this effect depends on the class of antidepressant used and the dosage. The extent of variation between the effects of antidepressants and sleep may relate to their mechanism of action. This systematic review examines randomised-controlled trials (RCTs) that have reported the effect that antidepressants appear to have on sleep. RCTs are not restricted to depressed populations, since several studies provide useful information about the effects on sleep in other groups. Nevertheless, the distinction is made between those studies because the participant's health may influence the baseline sleep profiles and the effect of the antidepressant. Insomnia is often seen with monoamine oxidase inhibitors (MAOIs), with all tricyclic antidepressants (TCAs) except amitriptyline, and all selective serotonin reuptake inhibitors (SSRIs) with venlafaxine and moclobemide as well. Sedation has been reported with all TCAs except desipramine, with mirtazapine and nefazodone, the TCA-related maprotiline, trazodone and mianserin, and with all MAOIs. REM sleep suppression has been observed with all TCAs except trimipramine, but especially clomipramine, with all MAOIs and SSRIs and with venlafaxine, trazodone and bupropion. However, the effect on sleep varies between compounds within antidepressant classes, differences relating to the amount of sedative or alerting (insomnia) effects, changes to baseline sleep parameters, differences relating to REM sleep, and the degree of sleep-related side effects.

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More information

Published date: 2005
Additional Information: Review Article
Keywords: antidepressants, sleep, review, randomised-controlled trials

Identifiers

Local EPrints ID: 27650
URI: http://eprints.soton.ac.uk/id/eprint/27650
ISSN: 0885-6222
PURE UUID: 371a95c9-4d19-45bc-b30b-5a88eda84764
ORCID for David S. Baldwin: ORCID iD orcid.org/0000-0003-3343-0907

Catalogue record

Date deposited: 25 Apr 2006
Last modified: 09 Jan 2022 02:48

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Contributors

Author: Andrew G. Mayers

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