Antidepressants for sleep problems

Antidepressant medicines are often prescribed for people with insomnia. Best results are seen in people who also have depression.¹ Doctors often prescribe low doses of certain antidepressants in an attempt to facilitate sleep, even though the medicines have not been well studied for insomnia.

Examples of the antidepressants that might be prescribed for insomnia are amitriptyline and trazodone.

The side effects of these medicines, which may include sexual dysfunction, weight gain, dry mouth and throat, racing pulse, confusion, and disturbed dreams, must be weighed against their potential benefits.

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

• A warning on the antidepressants Paxil and Paxil CR (paroxetine) and birth defects. One new study showed that women who took Paxil during their first 12 weeks of pregnancy had a slightly higher chance of having a baby with birth defects.
• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.

Citations

1. Mahowald MW (2008). Disorders of sleep. In L Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed., vol. 3, pp. 2696–2701. Philadelphia: Saunders Elsevier.