Sleep and Antidepressant Treatment

Wichniak, Adam; Wierzbicka, Aleksandra; Jernajczyk, Wojciech

doi:10.2174/138161212803523608

Cited by 142Sleep and related disordersTreatment of Major DepressionSleep and Wakefulness Research

Sleep and Antidepressant Treatment

Wichniak, Adam, Wierzbicka, Aleksandra, Jernajczyk, Wojciech·2012·Current Pharmaceutical Design

DOI 10.2174/138161212803523608

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Abstract

The aim of this review was to describe the sleep anomalies in depression, the effects of antidepressants on sleep, the usefulness of antidepressants in the treatment of primary insomnia and insomnia in other psychiatric disorders. Depression is associated with abnormalities in the sleep pattern that include disturbances of sleep continuity, diminished slow-wave sleep (SWS) and altered rapid eye movement (REM) sleep parameters. Although none of the reported changes in sleep are specific to depression, many of them, for example increased REM density and reduced amount of SWS in the first sleep cycle, are used as biological markers for research on depression and in the development of antidepressant drugs. An antidepressant should reverse abnormalities in the sleep pattern. However, many antidepressants can worsen sleep. Because of the activating effects of some drugs, for example imipramine, desipramine, fluoxetine, paroxetine, venlafaxine, reboxetine and bupropion, many patients who take them have to be co-prescribed with sleep-promoting agents to improve sleep. Even in maintenance treatment with activating antidepressants as many as 30-40% of patients may still suffer from insomnia. Antidepressants with sleep-promoting effects include sedative antidepressants, for example doxepin, mirtazapine, trazodone, trimipramine, and agomelatine which promotes sleep not through a sedative action but through resynchronization of the circadian rhythm. Sedative antidepressants are frequently used in the treatment of primary insomnia, although not many double-blind studies have been provided to support such an approach to insomnia treatment. One exception is doxepin, which has been approved for the treatment of insomnia characterized by difficulties in maintaining sleep.

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Mirtazapine, an antidepressant promoting sleep, may do so not through a sedative action but through resynchronization of the circadian rhythm.
“Mirtazapine, an antidepressant promoting sleep, may do so not through a sedative action but through resynchronization of the circadian rhythm.78”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [78]

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Authors: Wichniak, A., Wierzbicka, A., & Jernajczyk, W.
Affiliations: Institute of Psychiatry and Neurology (PL)
ORCID: Wichniak, Adam
Wierzbicka, Aleksandra
Jernajczyk, Wojciech
Venue: Current Pharmaceutical Design
Publisher: Bentham Science Publishers Ltd.
Published: 2012-10-13
Volume: 18
Issue: 36
Pages: 5802-5817
ISSN: 1381-6128 (ISSN-L)
DOI: 10.2174/138161212803523608
OpenAlex: W2127360167
Cited by: 142
References: 168
Citations by year: 2026: 15 · 2025: 11 · 2024: 14 · 2023: 6 · 2022: 8 · 2021: 8 · 2020: 16 · 2019: 10 · 2018: 6 · 2017: 12 · 2016: 9 · 2015: 12 · 2014: 8 · 2013: 5 · 2012: 2
FWCI: 11.57
Type: journal article
Language: en
Open access: closed
Locations: Current Pharmaceutical Design (publishedVersion)
PubMed (publishedVersion)
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: depression, sleep disorders, antidepressants, insomnia, slow-wave sleep, REM sleep, antidepressant side effects, doxepin, mirtazapine, trazodone, trimipramine, agomelatine, circadian rhythm, sleep maintenance
MeSH terms: Antidepressive Agents, Depression, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Risk Factors, Sleep, Sleep Wake Disorders, Treatment Outcome

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