Antidepressant medications are often prescribed for people with
insomnia. Best results are seen in people who have
underlying depression.1 Although there is little
evidence that they work in the absence of depression, doctors often prescribe
low doses of certain antidepressants in an attempt to facilitate sleep.
Examples of the antidepressants that might be prescribed for insomnia
are amitriptyline (such as Elavil) and trazodone (Desyrel).
The other side effects of these medications, which may include sexual
dysfunction, weight gain, dry mouth and throat, racing pulse, confusion, and
disturbed dreams, must be weighed against their potential benefits.2, 3
FDA Advisories. The US 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, but to watch for warning signs of suicide in those using
them. This is especially important at the beginning of treatment or when doses
are changed.
Working Group on Insomnia, National Heart, Lung, and
Blood Institute (1999). Insomnia: Assessment and management in primary care.
American Family Physician, 59(11):
3029–3038.
Kupfer DJ, Reynolds CF III (1997). Management of
insomnia. New England Journal of Medicine, 336(5):
341–346.
Bursztajn HJ (1999). Melatonin therapy: From
benzodiazepine-dependent insomnia to authenticity and autonomy. Archives of Internal Medicine, 159(20): 2393–2395.
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