Neural circuitry of wakefulness and sleep. Adverse effects of psychotropic medications on sleep. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine Clinical Practice Guideline. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. National use of prescription medications for insomnia: NHANES 1999-2010. Pharmacologic treatment of insomnia disorder: an evidence report for a clinical practice guideline by the American College of Physicians. Wilt TJ, MacDonald R, Brasure M, Olson CM, Carlyle M, Fuchs E, et al. Antidepressants and sleep: a qualitative review of the literature. Darien: American Academy of Sleep Medicine 2020. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, version 2.6. The use of polysomnography in the evaluation of insomnia. Reite M, Buysse D, Reynolds C, Mendelson W. Cognitive behavioral insomnia therapy for those with insomnia and depression: a randomized controlled clinical trial. 2016 77(10):e1316–23 This randomized control trial showed an additive effect of CBT-I on the treatment of major depression and insomnia.Ĭarney CE, et al. Efficacy of cognitive-behavioral therapy for insomnia combined with antidepressant pharmacotherapy in patients with comorbid depression and insomnia: a randomized controlled trial. 2017 38:122–9 This cohort study highlighted the role of insomnia relapse on depression risk. Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study. Depression in sleep disturbance: a review on a bidirectional relationship, mechanisms and treatment. Treating insomnia in depression: insomnia related factors predict long-term depression trajectories. 2018 13(1):13–9 This manuscript reviews the sleep architecture changes with age and side-effect profiles of insomnia treatment in elderly population.īei B, Asarnow LD, Krystal A, Edinger JD, Buysse DJ, Manber R. Incidence and risk factors of insomnia in a population-based sample. LeBlanc M, Mérette C, Savard J, Ivers H, Baillargeon L, Morin CM. Otte C, Gold SM, Penninx BW, Pariante CM, Etkin A, Fava M, et al. Papers of particular interest, published recently, have been highlighted as: Orexin antagonists may represent a future approach for treatment of both depression and insomnia. Low-dose doxepin is the only FDA-approved antidepressant for insomnia. Summaryĭata on the usage of most antidepressants for insomnia remain limited. Preclinical studies have shown potential antidepressant effects of orexin antagonists, which are used to treat insomnia. Trazodone, the most commonly used antidepressant, reduces the number of awakenings. Low-dose doxepin improves sleep continuity and is FDA approved for the treatment of chronic insomnia. TCA drugs can be sedating or stimulating. SSRI, SNRI, and TCA drugs reduce REM sleep and increase REM latency. Recent FindingsĪntidepressants remain commonly used off-label for the treatment of chronic insomnia. Given the strong bidirectional relationship between sleep disruption and psychiatric conditions, particularly between depression and insomnia, it is important to understand the beneficial and potentially harmful effects of antidepressants on sleep.
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