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Doctors
often prescribe antidepressants to treat insomnia. Antidepressants
have a history of producing positive results with those affected by
insomnia. They can be used long term. Antidepressants are not habit
forming, and so offer a relatively safe form of medication.
Antidepressants are normally given when anxiety or depression are
recognized as root causes for insomnia. However, there is very little
evidence to substantiate the use of antidepressants to treat insomnia
in non-depressed patients (Sharpley AL, Cowen PJ. Effect of
pharmacologic treatments on the sleep of depressed patients. Biol
Psychiatry 1995;37:85-98).
Antidepressants
have a range of adverse effects including anti-cholinergic effects,
cardiac toxicity, orthostatic hypotension and sexual dysfunction
(selective serotonin reuptake inhibitors [SSRIs]). Tricyclic
antidepressants and SSRIs can exacerbate restless legs syndrome and
periodic limb movement disorder in some patients. The lethal
dosage/effective dosage ratio for tricyclic antidepressants is
smaller than that for benzodiazepines (Walsh JK, Erman M, Erwin CW,
Jamieson A, Mahowald M, Regestein Q, et al. Subjective hypnotic
efficacy of trazodone and zolpidem in DSMIII-R primary insomnia.
Human Psychopharmacology 1998;13:191-8)
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