Display Settings:

Format

Send to:

Choose Destination

    CNS Drugs. 2009;23(4):309-29.

    Insomnia in patients with depression: some pathophysiological and treatment considerations.

    Jindal RD.

    University of Ottawa School of Medicine, Ottawa, Ontario, Canada. ripu.jindal@gmail.com

    The almost ubiquitous sleep disturbances in patients with depression commonly, but not always, subside with the remission of depression. Evidence linking insomnia with the risk of relapses in recurrent depression, as well as suicide, makes optimization of the treatment of insomnia associated with depression a priority. However, most antidepressant agents do not adequately address the sleep complaints in depression: their effects on sleep range from sizeable improvement to equally significant worsening. One approach to the management of insomnia associated with depression is to choose a sedating antidepressant agent such as trazodone, mirtazapine or agomelatine. A second approach is to start with a non-sedating antidepressant (e.g. the selective serotonin reuptake inhibitors, bupropion, venlafaxine or duloxetine); those with a persistent or treatment-emergent insomnia can be switched to a more sedating antidepressant, or offered a hypnotic or cognitive-behavioural therapy as adjunctive treatment. The review discusses the advantages and disadvantages of all treatment options, pharmacological and otherwise.

    PMID: 19374460 [PubMed - indexed for MEDLINE]

    Supplemental Content

    Click here to read

    Patient drug information

    • Bupropion (Aplenzin®, Wellbutrin®, Wellbutrin® SR, ...)

      Bupropion (Aplenzin, Wellbutrin, Wellbutrin SR, Wellbutrin XL) is used to treat depression. Bupropion (Wellbutrin XL) is also used to treat seasonal affective disorder (SAD; episodes of depression that occur in the fall ...

    • Venlafaxine (Effexor®, Effexor® XR)

      Venlafaxine is used to treat depression. Venlafaxine extended-release (long-acting) capsules are also used to treat generalized anxiety disorder (GAD; excessive worrying that is difficult to control), social anxiety diso...

    • Trazodone

      Trazodone is used to treat depression. Trazodone is in a class of medications called serotonin modulators. It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balan...

    • » See all 5 drug reports ...