SSRIs TO TREAT INSOMNIA – WHY THEY ARE NOT RECOMMENDED IN CERTAIN CASES
By Tess Thompson
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, SSRI’s 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 SSRI’s 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 and suggest that SSRIs 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 side effects like:
* 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 elated or irritable mood. They also cause thoughts and behaviors associated with such a mood on withdrawal. All classes of SSRIs therefore, must be tapered off gradually under professional guidance. Since SSRI’s also cause drowsiness, patients run the risk of bone fractures and injuries.
SSRIs, like other antidepressants, require adequate dosage for a continuous period of four to eight weeks to take affect. 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 prove 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 variants of insomnia including depression related insomnia.
References:
http://www.usnews.com/usnews/health/sleep/insomnia/insomnia.treat.meds.antidepr.htm
http://home.avvanta.com/~charlatn/depression/DepMeds.html#SSRI
http://www.angelfire.com/home/bphoenix1/ads.html
http://pn.psychiatryonline.org/cgi/content/full/40/17/30
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