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SSRIs to Treat Insomnia – Why they are not Recommended in Certain Cases

Tess Thompson

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Antidepressants are the most common type of drugs that are used in treating depression. Since insomnia is one of the most common symptoms of depression, these drugs are often used to elevate depressive moods and induce sleep.

Among the various kinds of antidepressants, SSRIs are among the latest that are now being used extensively for treating insomnia. Despite their rampant use, the efficacy of antidepressants like SSRIs to treat insomnia is not supported by clinical studies. Using SSRIs to treat insomnia has also not been approved by the FDA.

SSRIs are indicated mainly for clinical depression. This class of drugs should be used to treat insomnia only if it is one of the many symptoms of depression. However, primary care physicians tend to over-prescribe SSRIs and suggest that they be used for insomnia to get quicker results.

Different antidepressants have varying effects on depressive patients. An antidepressant is a drug that acts by blocking the reuptake of brain chemicals, like norepinephrine and serotonin, making more of those substances available to act on receptors in the brain. SSRIs act to maintain the level of serotonin (a neurotransmitter that is involved in sleep, memory and depression) by restricting its absorption.

Some of the selective serotonin inhibitors are:

• Fluoxetine (trade name Prozac)
• Paroxetine (trade name Paxil)
• Sertraline (trade name Zoloft)

All antidepressants have side effects, and SSRIs are no exception to the rule. SSRIs intake may produce the following side effects:

• Sleepiness
• Headaches
• Vivid dreams
• Drowsiness
• Nausea
• Loss of sexual urge
• Changes in appetite
• Weight loss or gain
• Liver or kidney damage

 SSRIs are also known to cause hypomania, a mood state characterized by lasting and permeating euphoric or irritable mood. They also cause thoughts and behaviors associated with such a mood on withdrawal. Therefore, all classes of SSRIs must be tapered off gradually under professional guidance.

SSRIs, like other antidepressants, require adequate dosage for a continuous period of four to eight weeks to take effect. In many cases, the side effects may surface before the drug has had the desired effect on the depression of the patient. Treating depression naturally by means of psychotherapy coupled with antidepressants proves more effective in treating depression-related insomnia than using either method as a standalone strategy.

Natural remedies for depression are another safer option for treating insomnia. Herbs and herbal teas, homeopathy and relaxation techniques like meditation and breathing exercise are time-tested remedies for treating all varieties of insomnia including depression-related insomnia.

References:
http://www.usnews.com/usnews/health/sleep/insomnia/insomnia
http://www.angelfire.com/home/bphoenix1/ads.html
http://pn.psychiatryonline.org/cgi/content/full/40/17/30