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Cited by 323Sleep and related disordersTreatment of Major DepressionSleep and Wakefulness Research

Antidepressants and their effect on sleep

Open access
Mayers, Andrew G., Baldwin, David S.·2005·Human Psychopharmacology: Clinical and Experimental
DOI 10.1002/hup.726
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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. Copyright © 2005 John Wiley & Sons, Ltd.

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Written from the paper’s full text.

TL;DR

This systematic review of RCTs finds that antidepressants have class- and dose-dependent effects on sleep, with insomnia, sedation, and REM suppression varying between and within classes. It synthesizes 120 papers, 53 of which were placebo-controlled, and links these effects to serotonergic, noradrenergic, and histaminergic mechanisms.

Key findings

  • Following exclusions, 120 papers were examined, 53 of which included placebo.
  • Insomnia is often seen with MAOIs, all TCAs except amitriptyline, all SSRIs, venlafaxine, and moclobemide; around one-quarter of depressed patients in clinical trials report insomnia with SSRIs.
  • 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 (especially clomipramine), all MAOIs and SSRIs, and with venlafaxine, trazodone and bupropion.

Methods

  • Systematic review exploring Ovid databases: CINAHL (1982–May 2005), EMBASE (1980–May 2005), Ovid MEDLINE (1966–May 2005), and PsychINFO (1985–May 2005).
  • Included double-blind randomised controlled trials with at least 5 participants per group, baseline and follow-up examination of antidepressant effects on sleep, and comparison to placebo and/or another antidepressant; papers were selected regardless of participant health.
  • Following exclusions, 120 papers were examined, 53 of which included placebo, presented in Table 1; findings are summarised by antidepressant class with proposed pharmacological mechanisms.

Limitations

  • Stated: there is a paucity of RCTs with MAOIs; no RCTs were found for reboxetine, escitalopram, lofepramine, or phenelzine; prospective RCTs specifically examining sleep are required for escitalopram; no RCTs explore mianserin effects on REM sleep; RCTs are scarce for milnacipran.
  • Evident: the review is a qualitative synthesis without meta-analysis; it combines heterogeneous populations (depressed, healthy, and other patient groups), doses, and sleep outcome measures, and many conclusions rest on single small trials, making between-drug comparisons indirect.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/hup.726

Cites

141 of 141 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

1 of 378 cited sources checked · 1 supported · 0 flagged

  • Findingnone given
    § Abstract

    Sedation has been reported with nefazodone.

    “Sedation has been reported with all TCAs except desipramine, with mirtazapine and nefazodone, the TCA-related maprotiline, trazodone and mianserin, and with all MAOIs.”
    Quote in the paperNot a substantial claim
  • Findingnone given
    § Abstract

    Sedation has been reported with all tricyclic antidepressants (TCAs) except desipramine.

    “Sedation has been reported with all TCAs except desipramine, with mirtazapine and nefazodone, the TCA-related maprotiline, trazodone and mianserin, and with all MAOIs.”
    Quote in the paperNot a substantial claim
  • Findingnone given
    § Abstract

    Insomnia is often seen with all tricyclic antidepressants (TCAs) except amitriptyline.

    “Insomnia is often seen with monoamine oxidase inhibitors (MAOIs), with all tricyclic antidepressants (TCAs) except amitriptyline, and all selective serotonin reuptake inhibitors (SSRIs), as well with venlafaxine and moclobemide.”
    Quote in the paperSubstantial claim
  • Findingnone given
    § Abstract

    Insomnia is often seen with monoamine oxidase inhibitors (MAOIs).

    “Insomnia is often seen with monoamine oxidase inhibitors (MAOIs), with all tricyclic antidepressants (TCAs) except amitriptyline, and all selective serotonin reuptake inhibitors (SSRIs), as well with venlafaxine and moclobemide.”
    Quote in the paperSubstantial claim
  • Findingnone given
    § Abstract

    Insomnia is often seen with venlafaxine.

    “Insomnia is often seen with monoamine oxidase inhibitors (MAOIs), with all tricyclic antidepressants (TCAs) except amitriptyline, and all selective serotonin reuptake inhibitors (SSRIs), as well with venlafaxine and moclobemide.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 175
  • Classified as probably not a substantial claim. 13
  • The quote only partly states this claim. 9

  • May combine two claims.

    Premisecitation
    § Monoamine oxidase inhibitors (MAOIs)

    MAOIs have been associated with increased sleep latency, poorer sleep efficiency, and increased nocturnal disturbances.

    “MAOIs have been associated with increased sleep latency, poorer sleep efficiency, and increased nocturnal disturbances (Winokur et al., 2001).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Winokur et al., 2001 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Trimipramine (150mg) was associated with improved sleep efficiency, longer sleep, and fewer nocturnal arousals, compared to fluoxetine (20mg), in depressed patients.

    “(Wolf et al., 2001) showed that trimipramine (150mg) was associated with improved sleep efficiency, longer sleep, and fewer nocturnal arousals, compared to fluoxetine (20mg).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wolf et al., 2001 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Desipramine (50-250mg) was associated with more nocturnal waking, shorter sleep, and less efficient sleep than amitriptyline (50-150mg).

    “In another study (Shipley et al., 1985), desipramine (50-250mg) was associated with more nocturnal waking, shorter sleep, and less efficient sleep than amitriptyline (50-150mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Shipley et al., 1985 source

  • May combine two claims.

    Findingcitation
    § Healthy participants

    Dothiepin (100mg) was associated with longer TST, shorter nocturnal disturbances, better sleep efficiency, and better sleep quality than fluvoxamine (100mg).

    “(Wilson et al., 2000) showed that dothiepin (100mg) was associated with longer TST, shorter nocturnal disturbances, better sleep efficiency, and better sleep quality than fluvoxamine (100mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilson et al., 2000 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Desipramine was associated with shorter sleep latency than fluvoxamine (200mg), and presented better sleep efficiency.

    “Desipramine was associated with shorter sleep latency than fluvoxamine (200mg), and presented better sleep efficiency.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kupfer et al., 1991 source

  • May combine two claims.

    Findingcitation
    § Other patient groups

    Amitriptyline (50-250mg) was associated with better improvements in Hamilton Rating Scale for Depression (HAMD) sleep scores than fluoxetine (20mg) in patients with chronic pain, although daytime drowsiness was a significantly greater problem with amitriptyline.

    “In a study of patients with chronic pain (Versiani et al., 1999), amitriptyline (50-250mg) was associated with better improvements in Hamilton Rating Scale for Depression (HAMD; (Hamilton, 1960)) sleep scores than fluoxetine (20mg), although daytime drowsiness was a significantly greater problem with amitriptyline.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Versiani et al., 1999 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Imipramine (50-200mg) significantly increased sleep latency, while trimipramine (50-250mg) was associated with a non-significant decrease.

    “(Sonntag et al., 1996) demonstrated that imipramine (50-200mg) significantly increased sleep latency, while trimipramine (50-250mg) was associated with a non-significant decrease; imipramine was associated with significantly less total sleep time, and significantly more nocturnal awakenings than trimipramine.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sonntag et al., 1996 source

  • May combine two claims.

    Findingcitation
    § Healthy participants

    Dothiepin (75-150mg) was associated with increased trouble in waking, but longer total sleep time than placebo, in healthy participants.

    “(Ramaekers et al., 1995) found that dothiepin (75-150mg) was associated with increased trouble in waking, but longer total sleep time than placebo.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ramaekers et al., 1995 source

  • May combine two claims.

    Findingcitation
    § Other patient groups

    In patients with skin complaints, total sleep time improved for those treated with nortriptyline (100mg), compared to placebo, but daytime sleepiness was reported as a problem in the treatment group.

    “In a study of patients with skin complaints (Hammack et al., 2002), total sleep time improved for those treated with nortriptyline (100mg), compared to placebo. However, daytime sleepiness was reported as a problem in the treatment group.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hammack et al., 2002 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Dothiepin (75-150mg) was associated with more immediate improvement of EGS and QOS perceptions on LSEQ than amitriptyline (75-100mg) or mianserin (30-75mg), although was similar to trazodone (150mg).

    “(Blacker et al., 1988) showed that dothiepin (75-150mg) was associated with more immediate improvement of EGS and QOS perceptions on LSEQ than amitriptyline (75-100mg) or mianserin (30-75mg), although was similar to trazodone (150mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Blacker et al., 1988 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    HAMD sleep scores were significantly reduced with dothiepin (150mg), compared to placebo (but were similar to doxepin).

    “(Ferguson et al., 1994) found that HAMD sleep scores were significantly reduced with dothiepin (150mg), compared to placebo (but were similar to doxepin).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ferguson et al., 1994

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Desipramine (100-200mg) significantly reduced sleep latency after just one day of treatment, but this significantly increased again within a week and throughout the remainder of the 4-week study.

    “(Kupfer et al., 1991) demonstrated that desipramine (100-200mg) significantly reduced sleep latency after just one day of treatment, but this significantly increased again within a week and throughout the remainder of the 4-week study.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kupfer et al., 1991 source

  • May combine two claims.

    Findingcitation
    § Healthy participants

    Clomipramine (25-75mg) was associated with slightly longer nocturnal awakenings than placebo, and almost completely suppressed REM sleep, in healthy participants.

    “(Lacey et al., 1977) found that clomipramine (25-75mg) was associated with slightly longer nocturnal awakenings than placebo, and almost completely suppressed REM sleep.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lacey et al., 1977

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Patients presented better improvement in early morning awakening and nocturnal wakings with amitriptyline (100-150mg) than imipramine (100-150mg), although only for those who had responded to treatment.

    “(Casper et al., 1994) showed that patients presented better improvement in early morning awakening, and nocturnal wakings with amitriptyline (100-150mg) than imipramine (100-150mg); although this was only for those who had responded to treatment.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Casper et al., 1994 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    There were no differences between clomipramine (50-150mg) and sertraline (50-200mg) on LSEQ and HAMD sleep scores, but both showed significant improvements on all four LSEQ factors.

    “(Lepine et al., 2000) demonstrated no differences between clomipramine (50-150mg) and sertraline (50-200mg) on LSEQ and HAMD sleep scores, but both showed significant improvements on all four LSEQ factors (Ease of getting to sleep (EGS); perceived quality of sleep (QOS); ease of awakening (EOA); and behaviour following wakefulness (BFW)).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Lepine et al., 2000 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Nortriptyline showed initial suppression of REM sleep, with prolonged REM latency and reduced REM proportion, but this rebounded in later REM periods to show greater REM production and density than placebo.

    “Nortriptyline also showed initial suppression of REM sleep, with prolonged REM latency and reduced REM proportion, but this rebounded in later REM periods to show greater REM production and density than placebo.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Reynolds, III et al., 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation
    § Healthy participants

    Dothiepin (75-150mg) was associated with poorer sleep efficiency than placebo (and fluoxetine 20mg), but shorter nocturnal awakenings than fluoxetine; REM sleep latency was significantly shorter for dothiepin than for fluoxetine.

    “(Wilson et al., 2002) demonstrated that dothiepin (75-150mg) was associated with poorer sleep efficiency than placebo (and fluoxetine 20mg), but shorter nocturnal awakenings than fluoxetine; REM sleep latency was significantly shorter for dothiepin than for fluoxetine.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilson et al., 2002 source

  • May combine two claims.

    Findingcitation
    § Other patient groups

    In patients with panic disorder or agoraphobia, imipramine (25-250mg) was associated with more sedation than placebo (although less than alprazolam; 110mg), but significantly more insomnia than placebo and alprazolam.

    “In a study of patients reporting panic disorder or agoraphobia, (Cassano et al., 1994) imipramine (25-250mg) was associated with more sedation than placebo (although less than alprazolam; 110mg), but significantly more insomnia than placebo and alprazolam.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cassano et al., 1994 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given
    § Monoamine oxidase inhibitors (MAOIs)

    There is a paucity of RCTs with MAOIs.

    “There is a paucity of RCTs with MAOIs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Amitriptyline (150mg) and fluoxetine (60mg) both produced significant REM sleep suppression.

    “(Kerkhofs et al., 1990) demonstrated that amitriptyline (150mg) and fluoxetine (60mg) both produced significant REM sleep suppression.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kerkhofs et al., 1990 source

  • May combine two claims.

    Findingcitation
    § Other patient groups

    Doxepin (25mg) was associated with significantly increased total sleep time, and significantly reduced sleep latency and length of nocturnal awakenings, compared to placebo, in insomnia patients and healthy volunteers.

    “Sleep efficiency and sleep quality were significantly improved for insomnia patients taking doxepin (25-50mg), compared to placebo (Hajak et al., 2001), while doxepin (25mg) was associated with significantly increased total sleep time, and significantly reduced sleep latency and length of nocturnal awakenings, compared to placebo with insomnia patients and healthy volunteers (Hajak et al., 1996).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hajak et al., 1996 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Amitriptyline (75mg) was associated with significantly shorter sleep latency, but more drowsiness, than fluoxetine (20mg) on the Line Analogue Rating Scale for Sedation (LARS) scale.

    “(Kerr et al., 1993) observed that amitriptyline (75mg) was associated with significantly shorter sleep latency, but more drowsiness, than fluoxetine (20mg) on the Line Analogue Rating Scale for Sedation (LARS) scale.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kerr et al., 1993 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Sleep scores on HAMD were significantly better improved for trazodone (50-100mg) than placebo, although the effect was better in lower doses.

    “(Mashiko et al., 1999) found that sleep scores on HAMD were significantly better improved for trazodone (50-100mg) than placebo, although the effect was better in lower doses.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Mashiko et al., 1999 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Sleep was significantly less efficient, and nocturnal awakenings were significantly greater, with fluoxetine (20-40mg) when compared to nefazodone (100-500mg).

    “(Rush et al., 1998) found that sleep was significantly less efficient, and nocturnal awakenings were significantly greater, with fluoxetine (20-40mg) when compared to nefazodone (100-500mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rush et al., 1998 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Sertraline showed better EGS scores than fluoxetine, but poorer EOA and BFW.

    “Although overall LSEQ scores were significantly improved for both groups, they differed on individual items: sertraline showed better EGS scores than fluoxetine, but poorer EOA and BFW.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bennie et al., 1995

  • May combine two claims.

    Findingcitation
    § Depressed patients

    HAMD sleep scores were improved following venlafaxine (25-200mg), but significantly less so than with trazodone, and no different to placebo.

    “(Cunningham et al., 1994) demonstrated that HAMD sleep scores were improved following venlafaxine (25200mg), but significantly less so than with trazodone, and no different to placebo.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cunningham et al., 1994 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Venlafaxine (225mg) was associated with significant REM sleep reduction, and significantly increased nocturnal disturbance, compared to placebo.

    “(Luthringer et al., 1996) found that venlafaxine (225mg) was associated with significant REM sleep reduction, and significantly increased nocturnal disturbance, compared to placebo.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Luthringer et al., 1996

  • May combine two claims.

    Findingcitation
    § Escitalopram

    Escitalopram (10-20mg) showed significantly better improvements on the Montgomery-Asberg Depression Rating Scale (MADRS) item 4 (sleep) at all time points (weeks 1, 4, 6 & 8); citalopram (20-40mg) was only significantly better at week 6.

    “In a recent pooled analysis (Lader et al., 2005), which compares data from RCTs involving citalopram and escitalopram, it was shown that escitalopram (10-20mg) showed significantly better improvements on the Montgomery-Asberg Depression Rating Scale (MADRS; Montgomery and Åsberg, 1979) item 4 (sleep) at all time points (weeks 1, 4, 6 & 8); citalopram (20-40mg) was only significantly better at week”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Lader et al., 2005 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Fluoxetine significantly suppressed REM sleep, while nefazodone significantly increased the time spent in REM sleep.

    “Fluoxetine significantly suppressed REM sleep, while nefazodone significantly increased the time spent in REM sleep.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rush et al., 1998 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Tranylcypromine (20-100mg) significantly increased REM sleep latency and almost completely suppressed REM sleep overall.

    “(Nolen et al., 1993) found that tranylcypromine (20-100mg) significantly increased REM sleep latency and almost completely suppressed REM sleep overall.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nolen et al., 1993 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Fluoxetine (20mg) was associated with less efficient, shorter and more disrupted sleep than trimipramine (150mg); fluoxetine suppressed REM sleep, whereas trimipramine did not.

    “(Wolf et al., 2001) demonstrated that fluoxetine (20mg) was associated with less efficient, shorter and more disrupted sleep than trimipramine (150mg); fluoxetine suppressed REM sleep, whereas trimipramine did not.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wolf et al., 2001 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Sleep time was less, and disruption greater, for paroxetine (20-40mg) compared to nefazodone (400-600mg).

    “(Hicks et al., 2002) found that sleep time was less, and disruption greater, for paroxetine (20-40mg) compared to nefazodone (400-600mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hicks et al., 2002 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Isocarboxazid (20mg) did not differ from placebo on HAMD sleep scores, but treatment responders tended to sleep better overall with isocarboxazid than with placebo.

    “(Giller et al., 1982) demonstrated that isocarboxazid (20mg) did not differ from placebo on HAMD sleep scores, but treatment responders tended to sleep better overall with isocarboxazid than with placebo.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Giller et al., 1982 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Sertraline (50-100mg) was associated with fewer reports of trouble in sleep initiation than fluoxetine (20-40mg), but with poorer perceptions on waking.

    “(Bennie et al., 1995) demonstrated that sertraline (50-100mg) was associated with fewer reports of trouble in sleep initiation than fluoxetine (20-40mg), but with poorer perceptions on waking.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bennie et al., 1995

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Sertraline (mean 142mg) suppressed REM sleep and increased sleep latency (although not significantly), compared to placebo.

    “(Jindal et al., 2003) found that sertraline (mean 142mg) suppressed REM sleep and increased sleep latency (although not significantly), compared to placebo.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Jindal et al., 2003 source

  • May combine two claims.

    Findingcitation
    § Healthy participants

    Although poorer subjective sleep quality was reported for fluvoxamine than dothiepin, perceptions upon waking were better.

    “Although poorer subjective sleep quality was reported for fluvoxamine than dothiepin, perceptions upon waking were better.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilson et al., 2000 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    HAMD sleep scores tended to show better improvement for fluoxetine (20mg) than placebo, but this was not significant.

    “(Satterlee and Faries, 1995) showed that HAMD sleep scores tended to show better improvement for fluoxetine (20mg) than placebo, but this was not significant.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Satterlee and Faries, 1995

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Fluvoxamine (100-300mg) was associated with poorer EGS ratings on the LSEQ than mianserin (60-180mg) but fluvoxamine was related to better BFW ratings.

    “(Perez and Ashford, 1990) showed that fluvoxamine (100-300mg) was associated with poorer EGS ratings on the LSEQ than mianserin (60-180mg) but fluvoxamine was related to better BFW ratings.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Perez and Ashford, 1990 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Improvements in sleep latency and total sleep time were not as marked for fluoxetine as they were for mirtazapine, which resulted in more efficient sleep and less nocturnal disturbances than fluoxetine.

    “However, improvements in sleep latency and total sleep time were not as marked for fluoxetine as they were for mirtazapine, which resulted in more efficient sleep and less nocturnal disturbances than fluoxetine.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Winokur et al., 2003 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    LSEQ scores were significantly more likely to be improved with paroxetine (15mg) than mianserin (30mg); paroxetine was significantly improved from baseline on all four factors; mianserin only for BFW.

    “(Dorman, 1992) demonstrated that LSEQ scores were significantly more likely to be improved with paroxetine (15mg) than mianserin (30mg); paroxetine was significantly improved from baseline on all four factors; mianserin only for BFW.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dorman, 1992 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Citalopram (10-60mg) was associated with significantly better HAMD sleep scores (from baseline), but did not differ from imipramine (50-100mg).

    “(Rosenberg et al., 1994) demonstrated that citalopram (10-60mg) was associated with significantly better HAMD sleep scores (from baseline), but did not differ from imipramine (50-100mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rosenberg et al., 1994 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Sleep latency was also increased with tranylcypromine, but patients reported deeper and more refreshed sleep than with brofaromine (50-250mg).

    “Sleep latency was also increased, but patients reported deeper and more refreshed sleep than with brofaromine (50-250mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nolen et al., 1993 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    REM sleep was shown to be significantly more suppressed with paroxetine than nefazodone, and subjective sleep ratings showed greater improvements with nefazodone.

    “REM sleep was shown to be significantly more suppressed with paroxetine than nefazodone, and subjective sleep ratings showed greater improvements with nefazodone.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hicks et al., 2002 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation
    § Reboxetine

    One uncontrolled study showed evidence of transient sleep disruption, but persistent REM suppression, with 2mg (b.d.) of reboxetine in 12 dysthymic patients.

    “No RCTs were found in the systematic review, but one uncontrolled study showed evidence of transient sleep disruption, but persistent REM suppression, with 2mg (b.d.) of reboxetine in 12 dysthymic patients (Ferini-Strambi et al., 2004), and (Kuenzel et al., 2004) found nocturnal disturbance and reduced sleep efficiency with reboxetine (8-10mg) in 8 depressed patients.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ferini-Strambi et al., 2004 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Citalopram (20-80mg) was associated with significant improvements in HAMD sleep scores, relative to placebo; although daytime sleepiness was a significantly greater problem for those taking citalopram than for placebo.

    “(Mendels et al., 1999) found that citalopram (20-80mg) was associated with significant improvements in HAMD sleep scores, relative to placebo; although daytime sleepiness was a significantly greater problem for those taking citalopram than for placebo.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Mendels et al., 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Subjective ratings for all LSEQ factors significantly improved with citalopram (20-60mg), although not as quickly as with mirtazapine (15-60mg).

    “(Leinonen et al., 1999) showed that subjective ratings for all LSEQ factors significantly improved with citalopram (2060mg), although not as quickly as with mirtazapine (15-60mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Leinonen et al., 1999 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    There were no differences between fluoxetine (20-40mg) and mirtazapine (15-45mg) in respect of HAMD sleep scores; both showing significant improvements.

    “(Winokur et al., 2003) found no differences between fluoxetine (20-40mg) and mirtazapine (15-45mg) in respect of HAMD sleep scores; both showing significant improvements.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Winokur et al., 2003 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    While fluvoxamine (100mg) and fluoxetine (20mg) did not differ in their effect on sleep in the first month of treatment, after that HAMD sleep scores were significantly better for fluvoxamine.

    “While fluvoxamine (100mg) and fluoxetine (20mg) did not differ in their effect on sleep in the first month of treatment, after that HAMD sleep scores were significantly better for fluvoxamine (Dalery and Honig, 2003).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dalery and Honig, 2003

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation
    § Healthy participants

    Fluoxetine (20mg) increased REM sleep latency and reduced overall REM proportion, increased sleep stages 2 and 3, increased sleep latency and worsened sleep efficiency, compared to placebo, in healthy participants.

    “(Vasar et al., 1994) demonstrated that fluoxetine (20mg) increased REM sleep latency and reduced overall REM proportion, increased sleep stages 2 and 3, increased sleep latency and worsened sleep efficiency, compared to placebo.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Vasar et al., 1994 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Sertraline (50-200mg) and clomipramine (50-150mg) significantly improved LSEQ (all factors) and HAMD sleep scores, but there were no between-group differences.

    “(Lepine et al., 2000) showed that sertraline (50-200mg) and clomipramine (50-150mg) significantly improved LSEQ (all factors) and HAMD sleep scores, but there were no between-group differences.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lepine et al., 2000 source

  • May combine two claims.

    Findingcitation
    § Healthy participants

    Fluvoxamine (100mg) was less disruptive to sleep than paroxetine (20mg), but tended to be associated with greater REM sleep suppression.

    “(Silvestri et al., 2001) found that fluvoxamine (100mg) was less disruptive to sleep than paroxetine (20mg), but tended to be associated with greater REM sleep suppression.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Silvestri et al., 2001 source

  • May combine two claims.

    Findingcitation
    § Healthy participants

    Nefazodone (200-400mg) reduced total sleep time, and increased nocturnal awakenings, when compared to placebo, in 120 healthy volunteers.

    “In contrast to some findings in depressed groups, (Vogel et al., 1998) showed that nefazodone (200400mg) reduced total sleep time, and increased nocturnal awakenings, when compared to placebo, in 120 healthy volunteers.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Vogel et al., 1998 source

  • May combine two claims.

    Findingcitation
    § Other patient groups

    Subjective ratings of sleep initiation, nocturnal awakenings, and sleep quality were significantly better for trazodone (50mg) than placebo for insomnia patients, but did not differ from the effects of the hypnotic drug zolpidem (10mg).

    “(Walsh et al., 1998) found that subjective ratings of sleep initiation, nocturnal awakenings, and sleep quality were significantly better for trazodone (50mg) than placebo for insomnia patients, but did not differ from the effects of the hypnotic drug zolpidem (10mg).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Walsh et al., 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Earlier analyses comparing mirtazapine to other antidepressants indicated less nocturnal disturbance and better sleep efficiency than with fluoxetine.

    “Earlier analyses comparing mirtazapine to other antidepressants, indicated less nocturnal disturbance and better sleep efficiency than with fluoxetine (Winokur et al., 2003) or paroxetine (Ridout et al., 2003), and better HAMD sleep scores than with paroxetine (Schatzberg et al., 2002) or venlafaxine (Guelfi et al., 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Winokur et al., 2003 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Earlier analyses comparing mirtazapine to other antidepressants indicated less nocturnal disturbance and better sleep efficiency than with paroxetine.

    “Earlier analyses comparing mirtazapine to other antidepressants, indicated less nocturnal disturbance and better sleep efficiency than with fluoxetine (Winokur et al., 2003) or paroxetine (Ridout et al., 2003), and better HAMD sleep scores than with paroxetine (Schatzberg et al., 2002) or venlafaxine (Guelfi et al., 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ridout et al., 2003 source

  • May combine two claims.

    Findingcitation
    § Other patient groups

    Trazodone (100mg) was associated with significantly better sleep efficiency and significantly less nocturnal disturbance than placebo in alcohol dependent patients.

    “(Le Bon et al., 2003) showed that trazodone (100mg) was associated with significantly better sleep efficiency and significantly less nocturnal disturbance than placebo in alcohol dependent patients.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Le Bon et al., 2003 source

  • May combine two claims.

    Findingcitation
    § Depressed patients

    Similar improvements for all LSEQ scores were demonstrated with trazodone (150mg) and mianserin (30-60mg), although trazodone tended to show more rapid improvements.

    “(Moon and Davey, 1988) demonstrated similar improvements for all LSEQ scores with trazodone (150mg) and mianserin (30-60mg), although trazodone tended to show more rapid improvements.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Moon and Davey, 1988 source

  • May combine two claims.

    Findingcitation
    § Mianserin

    There are no RCTs that explore the effects of mianserin on REM sleep, but uncontrolled studies have suggested slight suppression.

    “There are no RCTs that explore the effects of mianserin on REM sleep, but uncontrolled studies have suggested slight suppression (Maeda et al., 1991).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Maeda et al., 1991

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims. The quote only partly states this claim.

    Findingown data
    § Summary

    The few RCTs found during this review appear to support the findings that MAOIs cause greater nocturnal disturbance, shorter sleep times, and REM suppression.

    “The few RCTs that were found during this review appear to support these findings.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given
    § Abstract

    The extent of variation between the effects of antidepressants on sleep may relate to their mechanism of action.

    “The extent of variation between the effects of antidepressants and sleep may relate to their mechanism of action.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning
    § Abstract

    The effect of antidepressants on sleep depends on the class of antidepressant used and the dosage.

    “Current evidence suggests that this effect depends on the class of antidepressant used and the dosage.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Tricyclic Antidepressants (TCAs)

    BAP guidelines suggest that sedation 'may occur or is moderately strong' with imipramine, desipramine and nortriptyline.

    “The British Association for Psychopharmacology (BAP) guidelines (Anderson et al., 2000) suggest that sedation is 'relatively common or strong' with amitriptyline, dothiepin and clomipramine, while this 'may occur or is moderately strong' with imipramine, desipramine and nortriptyline.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Anderson et al., 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Depressed patients

    Unlike other tricyclic antidepressants (TCAs), desipramine is not associated with α1-adrenoceptor blockade, which may explain why it does not promote sleep as well.

    “Unlike other TCAs, desipramine is not associated with α1-adrenoceptor blockade (Wilson and Argyropoulos, 2005), which may explain why it does not promote sleep as well.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wilson and Argyropoulos, 2005 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Tricyclic Antidepressants (TCAs)

    BAP guidelines suggest that sedation is 'relatively common or strong' with amitriptyline, dothiepin and clomipramine.

    “The British Association for Psychopharmacology (BAP) guidelines (Anderson et al., 2000) suggest that sedation is 'relatively common or strong' with amitriptyline, dothiepin and clomipramine, while this 'may occur or is moderately strong' with imipramine, desipramine and nortriptyline.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Anderson et al., 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Monoamine oxidase inhibitors (MAOIs)

    MAOIs increase the availability of monoamines, but REM suppression often appears later than with TCAs and SSRIs.

    “MAOIs increase the availability of monoamines, but REM suppression often appears later than with TCAs and SSRIs (Wyatt et al., 1971).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wyatt et al., 1971

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Clomipramine

    Clomipramine may be associated with sedation, but has also been linked with insomnia.

    “Clomipramine may be associated with sedation, but has also been linked with insomnia (Anderson et al., 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Anderson et al., 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Monoamine oxidase inhibitors (MAOIs)

    Sedation is not reported with moclobemide, although minor insomnia has been noted.

    “Sedation is not reported with moclobemide, although minor insomnia has been noted (Anderson et al., 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Anderson et al., 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Selective serotonin reuptake inhibitors (SSRIs)

    EEG studies of sleep confirm that SSRIs immediately suppress REM sleep, and continue to do so throughout treatment; REM parameters return to normal once the SSRI is discontinued.

    “EEG studies of sleep confirm that SSRIs immediately suppress REM sleep, and continue to do so throughout treatment; REM parameters return to normal once the SSRI is discontinued (Winokur et al., 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Winokur et al., 2001 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Trazodone

    Trazodone has also shown to suppress REM sleep in some studies, which seems at odds with the relative lack of serotonin reuptake antagonism and the inhibition of 5-HT1A.

    “However, trazodone has also shown to suppress REM sleep in some studies (Mouret et al., 1988), which seems at odds with the relative lack of serotonin reuptake antagonism and the inhibition of 5-HT1A (Wilson and Argyropoulos, 2005).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Mouret et al., 1988 source
    • cites Wilson and Argyropoulos, 2005 source

  • May combine two claims.

    Premisenone given
    § Trazodone

    Trazodone is associated with weak serotonin reuptake blockade, and with antagonist actions at α1-adrenoceptors, 5-HT1A and 5-HT2 receptors.

    “Trazodone is associated with weak serotonin reuptake blockade, and with antagonist actions at α1adrenoceptors, 5-HT1A and 5-HT2 receptors.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given
    § Reboxetine

    Reboxetine inhibits the reuptake of noradrenaline, and is not associated with direct activity at postsynaptic receptor sites.

    “Reboxetine inhibits the reuptake of noradrenaline, and is not associated with direct activity at postsynaptic receptor sites.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisenone given
    § Venlafaxine

    Venlafaxine blocks the reuptake of serotonin and noradrenaline, mostly the former in lower doses (less than 150 mg), with little effect on post-synaptic receptor sites.

    “Venlafaxine blocks the reuptake of serotonin and noradrenaline, mostly the former in lower doses (less than 150 mg), with little effect on post-synaptic receptor sites.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Selective serotonin reuptake inhibitors (SSRIs)

    Both serotonin and noradrenaline reuptake blockade have been associated with REM suppression and sleep disruption.

    “Both actions have been associated with REM suppression and sleep disruption (Wilson and Argyropoulos, 2005).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wilson and Argyropoulos, 2005 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given
    § Selective serotonin reuptake inhibitors (SSRIs)

    By definition, SSRIs block serotonin reuptake, but some also block noradrenaline reuptake.

    “By definition, SSRIs block serotonin reuptake, but some also block noradrenaline reuptake.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Premisecitation
    § Healthy participants

    In healthy participants, milnacipran was associated with improvements in subjective sleep ratings (sleep latency, sleep quality and waking).

    “(Poirier et al., 2004) demonstrated that milnacipran was associated with improvements in subjective sleep ratings (sleep latency, sleep quality and waking), but did not differ from placebo in this respect.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Poirier et al., 2004 source

  • May combine two claims.

    Premisenone given
    § Nefazodone

    Nefazodone has mild serotonin reuptake blocking properties, and stronger 5-HT2 antagonist effects.

    “Nefazodone has mild serotonin reuptake blocking properties, and stronger 5-HT2 antagonist effects.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning
    § Mianserin

    Mianserin has been associated with sleep promotion properties, particularly in comparison to SSRIs, possibly through inhibition of histamine H1 receptors.

    “This compound has been associated with sleep promotion properties, particularly in comparison to SSRIs, as this review has shown, possibly through inhibition of histamine H1 receptors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning
    § Mirtazapine

    α2-adrenoceptor inhibition increases noradrenaline, thus suppressing REM sleep and disrupting sleep continuity; while the other actions tend to promote sleep.

    “α2-adrenoceptor inhibition increases noradrenaline, thus suppressing REM sleep and disrupting sleep continuity; while the other actions tend to promote sleep.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Milnacipran

    Milnacipran does not blockade histamine H1 or the α1-adrenoceptor site.

    “Milnacipran inhibits the reuptake of serotonin and noradrenaline (Bourin et al., 2005), but does not blockade histamine H1 or the α1-adrenoceptor site.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Bourin et al., 2005 source

  • May combine two claims.

    Premisecitation
    § Summary

    Amitriptyline, trimipramine, nortriptyline, dothiepin and doxepin have all been associated with sedation.

    “Amitriptyline (Hindmarch et al., 2000), trimipramine (Sonntag et al., 1996), nortriptyline (Hammack et al., 2002), dothiepin (Blacker et al., 1988) and doxepin (Hajak et al., 2001) have all been associated with sedation, while imipramine (Volkers et al., 2002) and desipramine (Shipley et al., 1985) are less likely to be linked with sedation, but have been associated with insomnia; the evidence is”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Hindmarch et al., 2000 source
    • cites Sonntag et al., 1996 source
    • cites Hammack et al., 2002 source

  • May combine two claims.

    Premisecitation
    § Summary

    EEG studies suggest that sleep length and efficiency are increased, and nocturnal disturbances reduced, for amitriptyline, clomipramine, trimipramine, nortriptyline and doxepin.

    “EEG studies suggest that sleep length and efficiency are increased, and nocturnal disturbances reduced, for amitriptyline (Casper et al., 1994), clomipramine (Eberhard et al., 1988), trimipramine (Wolf et al., 2001), nortriptyline (Reynolds, III et al., 1997) and doxepin (Hajak et al., 1996)”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Casper et al., 1994 source
    • cites Eberhard et al., 1988

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Wolf et al., 2001 source

  • May combine two claims.

    Premisenone given
    § Mirtazapine

    Mirtazapine blocks α2-autorecptors, 5-HT2 receptors and H1 receptors.

    “Mirtazapine blocks α2-autorecptors, 5-HT2 receptors and H1 receptors.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Premisecitation
    § Other psychotropic medications

    In depressed outpatients, significantly more patients showed improvements in sleep disturbance with fluoxetine plus clonazepam than with fluoxetine plus placebo.

    “Significantly more patients showed improvements in sleep disturbance in the cotherapy group than with placebo, although sedation was reported more often with cotherapy than with placebo.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Londborg et al., 2000 source

  • May combine two claims.

    Interpretationreasoning
    § Summary

    Antidepressants are associated with differing effects on sleep profiles, with variations between and within classes.

    “Antidepressants are associated with differing effects on sleep profiles, with variations between and within classes: sometimes there is conflicting evidence for individual compounds.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation
    § Mianserin

    Mianserin is an antagonist at α1-adrenoceptor sites and 5-HT2 receptors, which may promote sleep but also with inhibition of the α2-adrenoceptor, and with moderate inhibition of noradrenaline reuptake, which may fragment sleep and suppress REM sleep.

    “Mianserin is an antagonist at α1-adrenoceptor sites and 5-HT2 receptors, which may promote sleep but also with inhibition of the α2-adrenoceptor, and with moderate inhibition of noradrenaline reuptake (Wilson and Argyropoulos, 2005), which may fragment sleep and suppress REM sleep.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilson and Argyropoulos, 2005 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § References

    In depressed patients, there was no difference on HAM-D between amitriptyline and mirtazapine, but both showed decrease.

    “No difference on HAMDS between drugs, but both showed decrease (AMI: 4.90 vs. 1.74; MIR: 4.80 vs. 1.66; within-group significance not reported)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kasper, 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In opiate withdrawal patients, there was no difference between amitriptyline and lorazepam on LSEQ ratings except ease of waking, which was poorer for amitriptyline.

    “No difference between drugs on LSEQ ratings, except ease of waking (AMI 132.8, LOR 167.6; p=.047), suggesting poorer subjective waking for AMI”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Srisurapanont, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Summary

    In general, MAOIs are associated with greater nocturnal disturbance and shorter sleep times, with insomnia common.

    “In general, they are associated with greater nocturnal disturbance and shorter sleep times, with insomnia common (Winokur et al., 2001).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Winokur et al., 2001 source

      Checked before — its earlier verdict is held back until a new check runs.

  • May combine two claims.

    Interpretationnone given
    § Summary

    There are few differences between SSRIs, unlike TCAs.

    “There are few differences between SSRIs, unlike TCAs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Summary

    Mirtazapine appears to compare well with TCAs on sleep time and nocturnal disturbance, with a quicker, but less sustained improvement profile.

    “Mirtazapine appears to compare well with TCAs on sleep time and nocturnal disturbance, with a quicker, but less sustained improvement profile (Bruijn et al., 1999).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bruijn et al., 1999 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § References

    In elderly healthy volunteers, befloxatone maintained alertness.

    “BEF maintained alertness”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rosenzweig, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In severely depressed patients, both amitriptyline and alprazolam showed lengthened REM latency and less REM time.

    “Both groups showed lengthened REML, and less REM time”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hubain, 1990

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In depressed patients, both amitriptyline and fluoxetine significantly decreased REM% and increased REM latency, with no between-group differences.

    “Both groups sig decrease REM% (p<.001) and increase in REML (p<.001), but no between-group differences”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kerkhofs, 1990

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In gastric patients, amitriptyline produced poorer sleep efficiency, increased arousal, and reduced REM sleep compared to placebo.

    “AMI poorer SE, increased arousal, and reduced REM sleep, compared to PLC (no SWS)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Mertz, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In bruxism patients, amitriptyline did not increase total sleep time or reduce EMG activity compared to placebo.

    “AMI did not increase TST or reduce EMG activity, compared to PLC”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Raigrodski, 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In depressed patients, LSEQ scores significantly increased for both amitriptyline and fluoxetine, with no between-group differences.

    “LSEQ sig increased for AMI (94.7) & FLX (108.6), no between-group differences”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites De Ronchi, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given
    § Summary

    It is unlikely that a patient with a history of sleep disturbance will benefit from SSRI treatment.

    “It is unlikely that a patient with a history of sleep disturbance will benefit from SSRI treatment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § References

    In chronic pain patients, both amitriptyline and trazodone showed increase in total sleep time (approximately 2 hours per day; not significant), but actual time in bed was significantly more reduced in trazodone than amitriptyline.

    “Both groups showed increase in TST (approx 2 hrs per day; ns), but actual time in bed was sig more reduced in TRZ (4 hrs) than AMI (1.5; p=.005)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ventafridda, 1988

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Summary

    Greater disturbance, and less sleep, is reported with imipramine and desipramine.

    “Greater disturbance, and less sleep, is reported with imipramine (Volkers et al., 2002) and desipramine (Shipley et al., 1985).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Volkers et al., 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Shipley et al., 1985 source

  • May combine two claims.

    Premisecitation
    § References

    In elderly depressed patients, LSEQ scores improved in both amitriptyline and fluoxetine groups; amitriptyline had significantly shorter sleep latency at week 1 than fluoxetine.

    “LSEQ scores improved both groups; AMI sig shorter SL wk 1 than FLX (p<.05)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kerr, 1993

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In depressed patients, improvements in sleep were earlier for amitriptyline than imipramine, but only in treatment responders.

    “improvements earlier for AMI than IMI, but only in treatment responders”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Casper, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In depressed patients, both amitriptyline and paroxetine reduced REM sleep, but only paroxetine demonstrated an alerting effect.

    “Both drugs reduced REM sleep, but only PAR demonstrated an alerting effect”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Staner, 1995

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning
    § Summary

    No general comments can be made about 'other' antidepressants, since their mode of action varies widely.

    “No general comments can be made about 'other' antidepressants, since their mode of action varies widely.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § References

    In fibromyalgia patients, moclobemide showed no improvement in subjective sleep and fatigue, but placebo also showed improvement.

    “MOC group no improvement, but PLC group also showed improvement in these ratings (p<.05)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hannonen, 1998 source

  • May combine two claims.

    Premisecitation
    § References

    In fibromyalgia patients, self-reported sleep perceptions improved at days 15, 30, and 45 for paroxetine and at days 30 and 45 for amitriptyline, with no between-group differences.

    “Self-reported sleep perceptions improved at days 15, 30 & 45 for PAR (p<.01) and days 30 & 45 for AMI (p<.01); no between-group differences”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ataoglu, 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Clomipramine

    In depressed patients, both clomipramine and maprotiline showed significant improvement in sleep disturbance, with no between-group differences.

    “Sig improvement both groups sleep disturbance (p<.01); no between-group differences”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Eberhard, 1988

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Summary

    Nefazodone presents some of the more positive sleep outcomes of any antidepressant, frequently showing better sleep time and less disruption than SSRIs.

    “Nefazodone presents some of the more positive sleep outcomes of any antidepressant, frequently showing better sleep time and less disruption than SSRIs (Hicks et al., 2002).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hicks et al., 2002 source

  • May combine two claims.

    Premisecitation
    § Clomipramine

    In depressed outpatients, LSEQ items significantly increased from baseline in both clomipramine and sertraline groups, but no significant between-group differences; HAM-D significantly reduced for both groups, but no significant between-group differences.

    “LSEQ items sig increased from baseline in both groups (p<.001), but no sig between-group differences; HAMDS sig reduced for both groups (p value not specified), but no sig between groups differences”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lepine, 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In depressed patients, HAM-D scores reduced with both amitriptyline and fluoxetine, but significantly more with amitriptyline than fluoxetine.

    “HAMDS reduced with both drugs, but sig more for AMI (-3.3) than FLX (-1.9; p<.001)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Versiani, 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § References

    In chronic pain patients, amitriptyline group slept better from the second week compared to placebo, and slept longer, significantly so at week 2.

    “AMI group 'slept better' from second week, compared to PLC; AMI pts slept for longer than PLC pts, sig so at wk 2 (p<.01)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Zitman, 1990

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationnone given
    § Summary

    Patients' subjective sleep reports whilst taking SSRIs are frequently positive, as are clinicians' ratings.

    “Despite this, patients' subjective sleep reports whilst taking SSRIs are frequently positive, as are clinicians' ratings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § References

    In depressed patients, amitriptyline group showed significant reduction in HAM-D; no such change with femoxetine.

    “AMI group showed sig reduction in HAMDS; no such change with femoxetine”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Skrumsager, 1986 source

  • May combine two claims.

    Premisecitation
    § Summary

    Patient-rated LSEQ scores have been shown to improve with citalopram, sertraline and fluoxetine, comparing well with TCAs in this respect, although not so well as some newer antidepressants.

    “However, patient-rated LSEQ scores have been shown to improve with citalopram (Leinonen et al., 1999), sertraline and fluoxetine (Aguglia et al., 1993), comparing well with TCAs in this respect, although not so well as some of the newer antidepressants.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Leinonen et al., 1999 source
    • cites Aguglia et al., 1993 source

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed geriatric patients, trimipramine produced significantly higher sleep efficiency, longer total sleep time, and shorter wake after sleep onset; fluoxetine decreased REM% and increased REM latency.

    “TRIM sig higher SE (p<.05), longer TST (p<.05), shorter WASO (p<.01); FLX decreased REM% (p<.01) increased REML (p<.05)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wolf, 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Fluoxetine

    In depressed outpatients, HAMDS scores were improved for fluoxetine relative to placebo (but ns); HAMDS scores worsened more often with placebo than fluoxetine (ns); HAMDS scores improved more often with fluoxetine than placebo (ns).

    “HAMDS scores were improved for FLX relative to PLC (but ns); HAMDS scores worsened more often with PLC than FLX (ns); HAMDS scores improved more often with FLX than PLC (ns)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Satterlee, 1995

  • May combine two claims.

    Premisecitation
    § Citalopram

    In depressed patients in primary care, all groups increased (improved) MOS sleep scores, but there were no between-group differences.

    “All groups increase (improvement) MOS sleep scores, but no between-group differences”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kroenke, 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In depressed outpatients, sleep efficiency significantly increased with nefazodone (p=.05) and significantly reduced with fluoxetine (p=.05), with fluoxetine significantly poorer than nefazodone (p=.01); WASO significantly reduced with nefazodone (p=.01) and significantly increased with fluoxetine (p=.01), with fluoxetine significantly poorer than nefazodone (p=.01); SWS significantly reduced in

    “SE sig increased with NEF (p=.05), sig reduced with FLX (p=.05), FLX sig poorer than NEF (p=.01); WASO sig reduced with NEF (p=.01), sig increased with FLX (p=.01), FLX sig poorer than NEF (p=.01); SWS sig reduced both groups (p=.01); REM time sig reduced with FLX (p=.01), sig increased NEF (p=.01), NEF sig longer than FLX (p=.01); improvements sig greater for NEF than FLX on HAMDS (both improved)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rush, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In depressed patients, fluoxetine significantly decreased sleep efficiency and REM time, increased WASO and REM latency; nefazodone significantly decreased %AMT, but did not alter sleep efficiency, WASO, REM time, or REM latency; both groups showed significant improvement in some clinician- and patient-rated sleep disturbance scores, but the nefazodone group generally improved more than the flu

    “FLX sig decreased SE and REM time, increased WASO and REML; NEF sig decreased %AMT, but did not alter SE or WASO, REM time or REML; both groups showed sig improvement in some clinician- and patient-rated sleep disturbance scores, but NEF group generally improved more than FLX group”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Bennie, 1995 Gillin, 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Citalopram

    In atypical depressed patients, the sertraline group showed significant improvement on LSEQ Item 4 (integrity of behaviour on waking); there were no other sleep differences between groups.

    “SER group showed sig improvement on LSEQ Item 4 (integrity of behaviour on waking); no other sleep differences between groups”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sogaard, 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Moclobemide

    In insomnia patients, doxepin significantly increased sleep efficiency compared to placebo (p<.05) and significantly improved sleep quality (p<.001); however, patients with severe insomnia rebound after treatment withdrawal were significantly more likely to have taken doxepin than placebo.

    “DOX sig increased SE compared to PLC (p&lt;.05); DOX sig improved SQ (P&lt;.001); but, pts with severe insomnia rebound (after treatment withdrawal) were sig more likely to have taken DOX than PLC”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hajak, 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In depressed patients with melancholia, citalopram significantly improved HAMDS relative to placebo (p<.05), but somnolence was reported as a side effect in twice as many citalopram patients as placebo patients.

    “CIT group sig improvement in HAMDS relative to PLC (p&lt;.05), but somnolence reported as side effect in twice as many CIT group as PLC”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Mendels, 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed inpatients, mirtazapine produced rapid improvements in sleep at week 2, normalising by week 4; imipramine produced more gradual improvement, exceeding mirtazapine by week 4.

    “MIR rapid improvements in sleep wk 2, normalising by wk 4; IMI more gradual improvement, exceeding MIR by wk 4”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Bruijn, 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In insomnia patients, trimipramine did not suppress REM sleep; lormetazepam decreased wake minutes and slow-wave sleep, increased REM sleep, compared to placebo.

    “TRIM did not suppress REM sleep; LOR decreased WMINS and SWS, increased REM sleep, compared to PLC”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Riemann, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed male inpatients, imipramine significantly increased sleep latency by end of 4 weeks, significantly increased stage 1 sleep immediately and through 4 weeks, significantly reduced REM time immediately but significantly increased again to 4 weeks, and significantly increased REM latency immediately but significantly reduced this again to 4 weeks.

    “IMI sig increased SL by end of 4 wks, sig increased stage 1 sleep immediately and through to 4 wks, sig reduced REM time immediately, but sig increased again to 4 wks, sig increased REML immediately, but sig reduced this again to 4 wks”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Sonntag, 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In panic/agoraphobia patients, there was significantly more sedation for alprazolam than imipramine or placebo, and significantly more insomnia for imipramine than alprazolam and placebo.

    “Sig more sedation for ALP (58%) than IMI (31%) or PLC (21%); sig more insomnia for IMI (22%) than ALP (3%) and PLC (12%)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Cassano, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed inpatients, compared to amitriptyline, desipramine had significantly more wake after sleep onset, more wake minutes, less total sleep time, poorer sleep efficiency, and less REM time.

    “compared to AMI, DES sig more WASO (p<.01), more WMINS (p<.01), less TST (p<.05), poorer SE (p<.01) less REM time (p<.01)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Shipley, 1985

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed inpatients, desipramine significantly reduced sleep latency on day 1, increased it by day 7 to end, increased stage 2 sleep, reduced REM% at day 1 then increased, and increased REM latency at day 1 then decreased; fluvoxamine significantly increased sleep latency at day 1, decreased it day 7 to end (not significant), increased wake minutes, reduced sleep efficiency at day 1 returning到

    “DES sig reduced SL day 1, sig increased by day 7 to end (p=.01), sig increased stage 2 sleep day 1 to end (p<.001), sig reduced REM% at day 1, increased day 2 to end (p<.001), sig increased REML at day 1, decreased day 2 to end (p<.001); FLX sig increased SL at day 1 (p<.001), decreased day 7 to end (ns), sig increased WMINS at day 1 to end (p<.001), sig reduced SE at day 1, returning to baseline”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kupfer, 1991

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In healthy volunteers, nefazodone 400mg did not alter REM sleep and had little effect on sleep continuity.

    “NEF did not alter REM sleep and had little effect on sleep continuity”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sharpley, 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In depressed outpatients, subjective sleep did not differ between groups until week 4, then sleep quality favoured fluvoxamine (ns); HAMDS improvement was significantly greater with fluvoxamine than fluoxetine at weeks 4 and 6.

    “Subjective sleep did not differ between groups until wk 4, then SQ favoured FLUV (ns); HAMDS improvement was sig greater with FLUV than FLX at wks 4 and 6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dalery, 2003

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In healthy male volunteers, the fluoxetine group had longer REM latency than placebo and dothiepin on day 10 (p=.003), and both active groups had longer REM latency than placebo on day 36 (p=.03).

    “FLX group longer REML than PLC and DOT day 10 (p=.003); both active groups longer REML than PLC day 36 (p=.03);”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilson, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed inpatients, venlafaxine up to 225mg significantly reduced REM time compared to placebo at week 1 and month 1, and significantly reduced REM at week 1 (p<.05).

    “VEN sig less REM time than PLC wk 1 & month 1,VEN sig reduced REM wk 1 (p<.05)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Luthringer, 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed inpatients, venlafaxine up to 225mg significantly increased REM latency compared to placebo at both time points, with significant increase at week 1 (p<.01).

    “REML sig longer VEN than PLC at both time points, VEN sig increase REML wk 1 (p<.01)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Luthringer, 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed male inpatients, trimipramine significantly increased total sleep time after 4 weeks, significantly reduced wake minutes immediately and through 4 weeks, significantly increased REM time immediately and through 4 weeks, and significantly reduced REM latency immediately but increased again to 4 weeks (not significant).

    “TRIM sig increased TST, after 4 wks, sig reduced WMINS immediately and through to 4 wks, sig increased REM time immediately and through to 4 wks, sig reduced REML immediately, but increased again to 4 wks (ns)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Sonntag, 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In elderly bereaved depressed patients, nortriptyline (mean 70.8 mg) decreased REM time and increased REM density, while placebo produced no change; REM sleep in the nortriptyline group reverted to baseline after withdrawal, and subjective sleep quality returned to normal.

    “NOR decreased REM time and increased REM density; no change PLC; REM sleep NOR group reverted to baseline after withdrawal; subjective SQ returned to normal”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Taylor, 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • The quote only partly states this claim.

    Premisecitation
    § Moclobemide

    In healthy volunteers, no differences were detected on sleep variables between groups.

    “No differences detected on sleep variables between groups”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dingemanse, 1992

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed inpatients, fluoxetine and desipramine groups significantly differed on sleep latency (fluoxetine > desipramine), sleep efficiency (desipramine > fluoxetine), and REM latency (fluoxetine > desipramine).

    “groups sig differed on SL (FLX>DES), SE (DES>FLX) and REML (FLX>DES)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Shipley, 1985

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In depressed outpatients, mirtazapine showed better improvement in sleep latency and total sleep time compared to fluoxetine, with a trend for better sleep efficiency; fluoxetine showed non-significant reduction in SWS, increased WASO, increased REM latency, and reduced REM time (p=.033); mirtazapine showed significant reduction in sleep latency (p=.0015), longer total sleep time (p=.04), better

    “MIR better improvement SL &amp; TST, compared to FLX; trend better improvement SE for MIR; FLX non-sig reduction SWS, increased WASO, increased REML, reduced REM time (p=.033), non-sig reduction SWS; MIR showed sig reduction SL (p=.0015), longer TST (p=.04), better SE (p=.0004), less WASO (p=.0008)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rosenberg, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • The quote only partly states this claim.

    Premisecitation
    § Fluoxetine

    In depressed patients, there was a trend towards better LSEQ scores for morning dosing of paroxetine 15-30mg.

    “trend towards better LSEQ scores for am dosing”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wade, 1993

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In elderly depressed patients, mianserin 30mg worsened 4 LSEQ factors, mostly regarding poorer waking, but not significantly.

    “6 out of 10 LSEQ scores sig improved PAR, 1 factor sig increased MIA (p<.05); 4 of factors worsened MIA, mostly re poorer waking (ns)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dorman, 1992 source

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In healthy volunteers, fluoxetine significantly increased sleep latency (p=.03), reduced sleep efficiency (p=.03), increased REM latency (p=.04), reduced REM% (p=.01), increased stage 2% (p=.03), and increased stage 3% (p=.02); placebo was ns; there were no within/between-group differences in subjective sleep measures; sleep quality improved for the fluoxetine group (p=.03).

    “FLX sig increased SL (p=.03), reduced SE (p=.03), increased REML (p=.04), reduced REM% (p=.01), increased stage 2% (p=.03), increased stage 3% (p=.02), PLC ns; no within/between-group differences subjective sleep measures SQ improved for FLX group (p=.03)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Vasar, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In patients with severe pain, nortriptyline 100 mg was more likely to cause sleepiness as a side effect than placebo, but the difference was not significant (p=.09).

    “NOR more likely to report sleepiness as a side effect than PLC (ns; p=.09)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hammack, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed patients in primary care, all groups (imipramine, citalopram 10-30mg, citalopram 20-60mg) showed reduction in HAM-D, but not significantly between groups.

    “All groups showed reduction in HAMDS, but not sig between groups”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rosenberg, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In healthy volunteers, amitriptyline 75mg caused severe drowsiness that disappeared after 1 week.

    “AMI group showed severe drowsiness, but this disappeared after 1 week”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Robbe, 1995 source

  • May combine two claims.

    Premisecitation
    § Citalopram

    In depressed outpatients, both sertraline and fluoxetine groups showed significant improvement in LSEQ scores, but there was no difference between the groups; however, the fluoxetine group reported more insomnia than sertraline.

    “Both groups showed sig improvement in LSEQ scores, but there was no difference between the groups; although FLX group reported more insomnia than SER”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Aguglia, 1993

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Moclobemide

    In healthy volunteers, there were no differences in reports of sleep quality, but the mianserin group showed increased sleep and reported daytime drowsiness/fatigue; moclobemide appeared to have little effect on sleep.

    “No differences in reports of SQ, but MIA group showed increased sleep, and reported daytime drowsiness/fatigue; MOC appeared to have little effect on sleep”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ramaekers, 1992

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In healthy volunteers, paroxetine disrupted sleep more than fluvoxamine; REM sleep was suppressed (especially for fluvoxamine) and rebounded during withdrawal (especially for paroxetine).

    “PAR disrupted sleep more than FLUV; REM sleep suppressed (especially for FLUV) rebounded during withdrawal (especially for PAR)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Silvestri, 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In elderly recurrent depressed patients, nortriptyline (80-120 ng/mL) significantly lengthened sleep latency (p=.02) and REM latency (p=.01), reduced REM proportion (p=.001), increased REM density (p<.001), and increased REM production throughout (p<.001).

    “NOR sig longer SL (p=.02), longer REML (p=.01), less REM proportion (p=.001) greater REMD (p<.001) more REM production throughout (p<.001)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Reynolds, 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In healthy volunteers, paroxetine 30mg reduced REM sleep, increased REM latency and wake after sleep onset, and reduced total sleep time and sleep efficiency.

    “PAR reduced REM sleep, increased REML and WASO, reduced TST and SE”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sharpley, 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In patients with severe pain, nortriptyline 100 mg increased total sleep time by 0.5 hours over 9 weeks, while placebo decreased it by 0.3 hours (p=.02).

    “TST increased by 0.5 hours with NOR, decreased by 0.3 hours with PLC (p=.02);”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hammack, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed patients in primary care, there were no between-group differences on HAMDS between dothiepin and fluoxetine, but tiredness/drowsiness side effects were reported more often in the dothiepin group and response was quicker for dothiepin.

    “No between-group differences on HAMDS, but tiredness/drowsiness side effects reported more often in DOT group and response quicker for DOT”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Corne, 1989 source

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed patients presenting insomnia, both imipramine and trimipramine reported shorter sleep latency initially, but imipramine increased sleep latency after 7 days while trimipramine continued improving; total sleep time increased with trimipramine but decreased with imipramine.

    “Both groups reported shorter SL initially, but IMI increasing SL after 7 days, TRIM continued improving; TST increased TRIM, but decreased IMI (p=.02)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ware, 1989

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In healthy volunteers, dothiepin reported increased difficulty waking on days 1-3 (p=.043) and fluoxetine on days 17-21 (p=.02); dothiepin on days 1-3 estimated 43 minutes longer total sleep time than placebo (p=.02).

    “DOT reported increased difficulty waking days 1-3 (p=.043), FLX on days 17-21 (p=.02); DOT days 1-3 estimated 43 minutes longer TST than PLC (p=.02)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ramaekers, 1995

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In depressed patients with insomnia, there were no between-group differences in HAMDS, but both groups showed significant reduction from week 2 to week 8 (p<.05).

    “No between-group differences HAMDS; both sig reduction wk 2 to wk 8 (p&lt;.05);”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Leinonen, 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Moclobemide

    In insomnia patients, doxepin significantly improved sleep latency, total sleep time, and wake minutes in both study groups compared to placebo.

    “DOX sig improved SL, TST, and WMINS in both study groups, compared to PLC”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hajak, 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Moclobemide

    In depressed outpatients, no HAMDS score changed overall, although those who responded best to active drug tended to report less sleep disturbance.

    “No HAMDS score changed overall, although those who responded best to active drug tended to report less sleep disturbance”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hannonen, 1998 source

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed patients, there were no between-group differences on LSEQ scores between dothiepin and fluoxetine, but disturbed sleep/drowsiness side effects were reported more often in the dothiepin group.

    “No between-group differences on LSEQ scores, but disturbed sleep/drowsiness side effects reported more often in DOT group”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stephenson, 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In depressed patients, total sleep time, sleep efficiency, and wake minutes worsened with paroxetine and improved with nefazodone early in treatment, tending towards baseline by week 8; WASO was significantly worse by week 8 with paroxetine; REM latency significantly increased and REM time significantly reduced with paroxetine; nefazodone slightly decreased REM latency but increased REM time;

    “TST, SE and WMINS worsened PAR, improved NEF, early in treatment, tended towards baseline by wk 8; WASO sig worse by wk 8 PAR; REML sig increased, REM time sig reduced PAR; NEF slightly decreased REML but increased REM time; subjective data (SMHSQ) indicated greater improvements in SQ and depth of sleep for NEF; no LSEQ factor showed sig between-group differences”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hicks, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • The quote only partly states this claim.

    Premisecitation
    § Fluoxetine

    In depressed patients, morning dosing of paroxetine 15-30mg resulted in significantly better HAMDS scores than evening dosing.

    “HAMDS sig better for am dosing”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wade, 1993

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • The quote only partly states this claim.

    Premisecitation
    § Citalopram

    In depressed patients, there were no between-group differences between sertraline, fluoxetine, and paroxetine in respect of worsening or improvement of insomnia.

    “No between-group differences in respect of worsening or improvement of insomnia”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fava, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In healthy volunteers, paroxetine and mirtazapine reported significantly increased sedation (LARS); there was significant lengthening of LSEQ sleep latency for paroxetine vs MIRC on day 2, but not vs placebo; significant reduction in sleep latency for MIRPC vs placebo; sleep latency was significantly higher for paroxetine vs other treatments on day 3; sleep latency was significantly lower for MIR

    “PAR and MIR reported sig increased sedation (LARS); sig lengthening LSEQ SL PAR vs MIRC day 2, not PLC; sig reduction SL MIRPC vs PLC; SL sig higher PAR vs other treatments day 3; SL sig lower MIRPC vs other treatments wk 4; LSEQ SQ sig poorer PAR vs PLC, sig better both MIR groups vs PLC; MESS indicated increased sleepiness with MIRPC days 1 and 2, with no other sig effects”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ridout, 2003

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In healthy male volunteers, the dothiepin group had poorer sleep efficiency than fluoxetine and placebo on day 36 (p=.04), and the fluoxetine group had more wake minutes than dothiepin on day 10 (p=.03).

    “DOT group poorer SE than FLX & PLC day 36 (p=.04); FLX group more WMINS than DOT day 10 (p=.03)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilson, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Imipramine

    In depressed patients presenting insomnia, total sleep time and sleep efficiency significantly improved for trimipramine, wake after sleep onset was greater for imipramine than trimipramine, REM latency significantly increased for imipramine while trimipramine had no change, and REM% significantly decreased for imipramine while trimipramine had no change.

    “TST and SE sig improved for TRIM (P<.01), WASO greater for IMI than TRIM (P<.01), REML sig increased for IMI, TRIM no change, REM% sig decreased for IMI (P<.01), TRIM no change”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ware, 1989

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Fluoxetine

    In healthy volunteers, the combination of mirtazapine and paroxetine (CT) got to sleep more easily and quickly and felt more drowsy at sleep onset than paroxetine alone; CT felt less drowsy at sleep onset than mirtazapine alone; there were no between-group differences in sleep quality; CT tended to have greater difficulty waking than paroxetine alone, no different to mirtazapine alone; CT felt

    “LSEQ: CT got to sleep more easily and quickly, felt more drowsy at sleep onset than PAR alone; CT group felt less drowsy at sleep onset than MIR alone; no between-group differences SQ; CT tended to have greater difficulty waking than PAR alone; no different to MIR alone; CT felt more tired on waking, PAR alone; no different to MIR alone”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ruwe, 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Mianserin

    In depressed outpatients, there were no significant between-group differences on LSEQ, but all groups significantly reduced throughout (including placebo).

    “no sig between-group differences LSEQ, but all sig reduced throughout (including PLC)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Edwards, 1983 source

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed patients, both trazodone 150mg and mianserin 30-60mg showed significant improvements on LSEQ factors for ease of getting to sleep, sleep quality, ease of waking, and feelings upon waking (p<.0001), with no significant differences between them.

    “Both groups showed sig improvements on LSEQ factors for ease of getting to sleep, sleep quality, ease of waking, and feelings upon waking (p<.0001), but no sig differences between them”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Moon, 1988 source

  • May combine two claims.

    Premisecitation
    § Mirtazapine

    In depressed patients, total sleep time estimates increased in both fixed-dose and escalating-dose mirtazapine groups, but fixed dose exceeded escalating dose at weeks 1 (p=.01) and 2 (p=.04).

    “TST estimates increased both groups, but FD exceeded ED wks 1 (p=.01) and 2 (p=.04)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Radhakishun, 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Mianserin

    In depressed outpatients, mianserin 30-90mg was significantly better than placebo at reducing early insomnia on day 14 (p<0.05), with no other significant between-group differences on HAMDS.

    “MIA sig better than PLC at reducing early insomnia day 14 (p<0.05), no other sig between-group differences HAMDS”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Edwards, 1983 source

  • May combine two claims.

    Premisecitation
    § Nefazodone

    In healthy volunteers, nefazodone 200-400mg left REM time, REM latency, REM density, and REM% unchanged relative to baseline and placebo.

    “REM time, REML, REMD & REM% all remained unchanged, relative to baseline and PLC”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Vogel, 1998 source

  • May combine two claims.

    Premisecitation
    § Mirtazapine

    In healthy volunteers, subjective sleep ratings (adapted from LSEQ) improved with milnacipran 50mg but there were no between-group differences.

    “Subjective sleep ratings (adapted from LSEQ) improved but no between-group differences”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Poirier, 2004

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed patients, all groups (trazodone, amitriptyline, dothiepin, mianserin) showed improved ease of getting to sleep and quality of sleep; this was immediate, although greatest for trazodone and dothiepin (p values not specified).

    “All groups showed improved ease of getting to sleep and quality of sleep; this was immediate, although greatest for TRZ and DOT (p values not specified)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Blacker, 1988

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Nefazodone

    In healthy volunteers, sleep latency was significantly greater for nefazodone 100mg and 200mg, but not imipramine, than placebo (p<.05) on day 1; no significant differences by day 7.

    “SL sig greater for NEF 100mg and NEF 200mg, but not IMI, than PLC (p<.05) on day 1; no sig differences by day 7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Van Laar, 1995

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In primary insomniac patients, trazodone 50mg and zolpidem 10mg both significantly improved ratings of ease of falling asleep, WASO, WMINS, and sleep quality compared to placebo (p=.005, p=.04, p=.002, p=.003 respectively).

    “Both groups sig better ratings ease falling asleep (p=.005), WASO (p=.04), WMINS (p=.002) & SQ (p=.003) than PLC, no differences TRZ vs ZOL”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Walsh, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed patients with insomnia, Y-NH HDSI sleep scores were significantly better for trazodone 50-100mg than placebo for middle insomnia (p=.03), late insomnia (p=.005), and overall sleep scores (p=.008).

    “Y-NH HDSI sleep scores sig better for TRZ than PLC middle insomnia (p=.03), late insomnia (p=.005) & overall sleep scores (p=.008)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nierenberg, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Mirtazapine

    In depressed patients, LSEQ 'getting to sleep' improved in both fixed-dose and escalating-dose mirtazapine groups, similar until week 2, when fixed dose was significantly better than escalating dose (p=.021).

    “LSEQ 'getting to sleep; GTS' improved both groups, similar between groups until wk 2, when GTS for FD sig better than ED (p=.021)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Radhakishun, 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Mirtazapine

    In depressed male patients, REM% was unchanged with CBT and fluoxetine, but increased with bupropion (p<.01).

    “REM% was unchanged with CBT and FLX, but increased with BUP (p<.01)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nofzinger, 1995 source

  • May combine two claims.

    Premisecitation
    § Mianserin

    In healthy volunteers, subjective estimates of total sleep time increased with mirtazapine and mianserin throughout (p<.001), with no between-group differences.

    “Subjective estimates TST increased MIR and MIA throughout (p<.001), no between-group differences”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ramaekers, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In healthy volunteers, nefazodone 200mg significantly increased REM% compared to placebo, while trazodone 100mg and buspirone 10mg significantly decreased REM% compared to placebo.

    “NEF sig more REM% than PLC, but TRZ & BUS sig less REM% than PLC”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ware, 1994 source

  • The quote only partly states this claim.

    Premisecitation
    § Mirtazapine

    In non-depressed smokers, no differences were found between bupropion (150mg or 300mg) and placebo regarding HAMDS scores on nicotine withdrawal.

    “No differences found between BUP and PLC regarding HAMDS scores on nicotine withdrawal”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Shiffman, 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed patients with insomnia, trazodone 50-100mg had significantly lower (better) PSQI TST score (p=.003) and overall score (p=.01) than placebo.

    “TRZ sig lower (better) PSQI TST score (p=.003), sig lower overall score (p=.01) than PLC”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nierenberg, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed patients with insomnia, self-rated total sleep time was significantly longer for trazodone 50mg vs 100mg, and 75mg vs 100mg.

    “self-rated TST sig longer for 50mg vs. 100mg, and 75mg vs. 100mg”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Mashiko, 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In healthy volunteers, nefazodone 200mg caused significantly less % stage 2 sleep than all other groups, and significantly less stage 3% than trazodone and buspirone.

    “NEF sig less % stage 2 sleep than all other groups, sig less stage 3% than TRZ and BUS”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ware, 1994 source

  • May combine two claims. The quote only partly states this claim.

    Premisecitation
    § Mianserin

    In depressed women, mianserin 10-20mg reduced HAMDS by the end of the trial, while placebo did not.

    “MIA reduced HAMDS, by end of trial; not PLC”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Costa, 1985

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Mirtazapine

    In depressed male patients, REM latency increased with CBT, dramatically increased for fluoxetine, but decreased for bupropion (p<.0001).

    “REML increased with CBT, dramatically increased for FLX, but decreased for BUP (p<.0001)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nofzinger, 1995 source

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed patients with insomnia, more patients improved with trazodone 50-100mg than placebo on PSQI (p=.004) and Y-NH HDSI sleep scores (p=.008).

    “more pts improved with TRZ than PLC on PQSI (p=.004) and Y-NH HDSI sleep scores (p=.008)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nierenberg, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Mirtazapine

    In depressed male patients, sleep efficiency increased for all groups, but particularly for bupropion (p<.05).

    “SE increased for all groups, but particularly for BUP (p<.05)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nofzinger, 1995 source

  • May combine two claims.

    Premisecitation
    § Mirtazapine

    In healthy young volunteers, mirtazapine 30mg improved sleep continuity compared to placebo, increased sleep efficiency, decreased WASO and WMINS.

    “MIR improved sleep continuity, compared with PLC, increased SE, decreased WASO and WMINS”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Aslan, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In primary insomniac patients, sleep latency decreased and total sleep time increased with both zolpidem 10mg and trazodone 50mg (p<.05).

    “SL decreased & TST increased ZOL and TRZ (p<.05)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Walsh, 1998

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Mirtazapine

    In depressed patients, bupropion responders showed increased REM latency, while non-responders showed decreased REM latency, a significant relationship.

    “but BUP responders showed increase REML, non-responders showed decrease - a sig relationship”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ott, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Venlafaxine

    In depressed patients, feelings upon awakening were impaired in all groups until day 7, when these measures improved in all groups except mianserin, where improvement started at day 14.

    “feelings upon awakening were impaired in all groups until day 7, when these measures improved (in all groups except MIA, where improvement started at day 14)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Blacker, 1988

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

189 of 189

  • The paper relies on this without support.

    There is a relationship between sleep and depression.

    “Given the relationship between sleep and depression, there is inevitably going to be an effect of antidepressants on sleep.”

  • The authors state this as an assumption.

    Antidepressant effects on sleep may vary with the current health of the participant.

    “Antidepressant effects on sleep may vary with the current health of the participant and it is important to make that distinction.”

  • The authors state this as an assumption.

    The dose of antidepressant may explain some of the variation between studies in similar participant groups.

    “Careful consideration is also paid to the dose of antidepressant as that may explain some of the variation between studies in similar participant groups.”

  • The paper relies on this without support.

    Most tricyclic antidepressants (TCAs) inhibit the reuptake of both serotonin and noradrenaline.

    “Most TCAs inhibit the reuptake of both serotonin and noradrenaline, but the relative extent that they do this varies, and may explain some of the differences in sedation and REM sleep suppression.”

  • The paper relies on this without support.

    The relative extent that tricyclic antidepressants (TCAs) inhibit reuptake of serotonin and noradrenaline varies.

    “Most TCAs inhibit the reuptake of both serotonin and noradrenaline, but the relative extent that they do this varies, and may explain some of the differences in sedation and REM sleep suppression.”

  • The paper relies on this without support.

    All tricyclic antidepressants (TCAs) except lofepramine block histamine H1 receptors, and all but desipramine block α1-adrenoceptors.

    “All TCAs except lofepramine block histamine H1 receptors, and all but desipramine block α1adrenoceptors.”

  • The paper relies on this without support.

    Sleep disturbance is often found with antidepressants, particularly in the form of insomnia with SSRIs.

    “Since sleep disturbance is often found with antidepressants, particularly in the form of insomnia with SSRIs, hypnotic medications have been added to an antidepressant to offset the sleep problem.”

  • The paper relies on this without support.

    The effect that an antidepressant has on sleep is important because it may influence the clinician's decision regarding which antidepressant to prescribe to which patient.

    “The effect that an antidepressant has on sleep is important because it may influence the clinician's decision regarding which antidepressant to prescribe to which patient.”
8 of 8

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Fluvoxamine-imipramine sleep fragmentation comparison reverses direction

    Major

    The fluvoxamine section says fluvoxamine caused more fragmented sleep than imipramine, but the table reports more fragmentation of motor activity during sleep with imipramine than fluvoxamine in the cited study.

  • Opposite alerting effects attributed to the same trial

    Major

    The amitriptyline section says amitriptyline was more alerting than paroxetine, while the paroxetine section says the reverse, both citing Staner et al. (1995).

  • Placebo comparison attributed to a dose-ranging trazodone trial

    Major

    The discussion claims Mashiko et al. (1999) found significantly better sleep scores with trazodone than placebo, but the table identifies it as a dose-ranging comparison among trazodone doses, not a placebo comparison.

  • REM findings attributed to a NonREM-only study

    Minor

    The text attributes a finding about REM sleep parameters to Carette et al. (1995), whereas the table says that study investigated only NonREM parameters.

  • Nortriptyline concentration reported as a dose

    Minor

    The discussion gives 80-120 mg for the Reynolds et al. (1997) study, but the table gives 80-120 ng/mL, a concentration rather than a dose.

  • Nefazodone study has conflicting participant counts

    Minor

    The discussion says the Vogel et al. (1998) study involved 120 healthy volunteers; its table row lists 22.

  • Claim of sedation with all MAOIs conflicts with moclobemide description

    Minor

    The abstract reports sedation with all MAOIs, but the MAOI section identifies moclobemide as a reversible MAOI and says sedation is not reported with it.

7 of 7

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. 10.1177/026988110001400101 · DOI
  2. Fann WE, 1984, Nomifensine vs. imipramine in depressed inpatients, J Clin Psychiatry., 45, 60
  3. Hameroff SR, 1982, Doxepin effects on chronic pain, depression and plasma opioids, J Clin Psychiatry., 43, 22
  4. 10.1002/(SICI)1099-1077(1998110)13:2 <S87::AID-HUP53>3.0.CO;2-8 · DOI
  5. Wade A, 1993, Efficacy, tolerability and effect on sleep of morning and evening doses of paroxetine in depressed patients, Br J Clin Res, 4, 105

Cited by

Sorted by citations

Related

Authors
Mayers, A. G., & Baldwin, D. S.
Affiliations
  • Southampton Solent University (GB)
  • University of Southampton (GB)
Corresponding author
Mayers, Andrew G.
ORCID
Venue
Human Psychopharmacology: Clinical and Experimental
Publisher
Wiley
Published
2005-10-17
Volume
20
Issue
8
Pages
533-559
ISSN
  • 0885-6222 (ISSN-L)
  • 1099-1077
DOI
10.1002/hup.726
OpenAlex
W2126469441
Cited by
323
References
141
Citations by year
2026: 6 · 2025: 12 · 2024: 6 · 2023: 11 · 2022: 11 · 2021: 13 · 2020: 13 · 2019: 16 · 2018: 14 · 2017: 17 · 2016: 23 · 2015: 16 · 2014: 19 · 2013: 10 · 2012: 20
FWCI
2.38
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Human Psychopharmacology Clinical and Experimental (publishedVersion)
  • PubMed (publishedVersion)
  • Bournemouth University Research Online (Bournemouth University) (submittedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
antidepressants, sleep, insomnia, sedation, REM sleep suppression, monoamine oxidase inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, mirtazapine, trazodone, venlafaxine, moclobemide, antidepressant side effects, depression
MeSH terms
Antidepressive Agents, Humans, Sleep

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-11-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-11-07.

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