Antidepressants for insomnia in adults

Abstract

We identified relatively few, mostly small studies with short-term follow-up and design limitations. The effects of SSRIs compared with placebo are uncertain with too few studies to draw clear conclusions. There may be a small improvement in sleep quality with short-term use of low-dose doxepin and trazodone compared with placebo. The tolerability and safety of antidepressants for insomnia is uncertain due to limited reporting of adverse events. There was no evidence for amitriptyline (despite common use in clinical practice) or for long-term antidepressant use for insomnia. High-quality trials of antidepressants for insomnia are needed.

Anesthesia and sleep disorders – a new problem in modern anesthesiology (literature review)

“…Стосовно медикаментозних засобів, наразі не існує "ідеального" регулятора сну. Серед препаратів першої лінії з ефектом, наближеним до фізіологічного, слід виділити декілька груп [41][42][43][44][45][46] Паралельно з цільовою терапією інсомнії необхідно проводити післяопераційне знеболення, яке є окремим напрямком менеджменту пацієнтів. Вище було показано, що біль негативно впливає на якість сну, але в останні роки формується думка, що ці процеси не односпрямовані, а взаємопов'язані [47].…”

Little evidence that antidepressants are effective for insomnia

“…3,4 However, a Cochrane review has found insufficient evidence to support the use of antidepressants for insomnia. 4 …”

“…4 Most studies were small and of low quality. Three studies that assessed SSRIs (135 participants) found no improvement over placebo for fluoxetine and some improvement in subjective measures for paroxetine.…”

“…4 Pooled analysis of three studies (370 participants) found a moderate improvement over placebo in subjective sleep outcomes with trazadone, but this was contradicted in two polysomnography studies (169 participants), which found little or no difference in sleep efficiency with trazadone compared to placebo. There was low-quality evidence from two studies that trazodone was associated with more adverse effects than placebo (morning grogginess, dry mouth and thirst).…”

“…4 The effects of SSRIs compared with placebo were unclear as there were too few studies available from which to draw clear conclusions. They also noted that the tolerability and safety of antidepressants for insomnia were uncertain because of low reporting of adverse events.…”