Antidepressants and Sleep

Antidepressants are crucial in managing mental health conditions like depression and anxiety. However, many patients are curious about how these medications might influence their sleep patterns. In this comprehensive guide, we will explore the 10 most common types of antidepressants prescribed in the UK, with a specific focus on SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors). We’ll delve into the intricate relationship between antidepressants and sleep, helping you make informed decisions to effectively manage your mental health while optimising your sleep quality.

1. Selective Serotonin Reuptake Inhibitors (SSRIs):

Common SSRIs: These include Fluoxetine (Prozac), Sertraline (Zoloft), and Escitalopram (Lexapro).

SSRIs, often the first choice for treating depression, work by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers, or neurotransmitters, that carry signals between brain nerve cells, and SSRIs work by blocking the reabsorption of serotonin into these nerve cells. SSRIs can initially disrupt sleep for some individuals. Common sleep disturbances include insomnia, vivid dreams, or daytime drowsiness. Fortunately, these side effects tend to improve as your body adjusts to the medication.

2. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):

Common SNRIs: These include Venlafaxine (Effexor) and Duloxetine (Cymbalta).

SNRIs share similarities with SSRIs and work in the same way, although they impact both serotonin and norepinephrine. They can lead to sleep disturbances such as insomnia and vivid dreams. These side effects typically subside as your body adapts to the medication.

3. Other Types of Antidepressants:

Bupropion (Wellbutrin): This aminoketone antidepressant works differently than SSRIs or SNRIs. Rather than impacting serotonin, it works to stop your brain nerve cells from reabsorbing dopamine and norepinephrine. It is also used to treat seasonal affective disorder and to help you stop smoking. Bupropion is more frequently prescribed in the USA and is less likely to disrupt sleep.

Mirtazapine: Categorised as a noradrenergic and specific serotonergic antidepressant (NaSSA), meaning it increases the amount of mood-enhancing chemicals noradrenaline and serotonin in your brain, Mirtazapine can initially seem to improve sleep due to its sedative effects. It can be prescribed for depression, OCD and sometimes anxiety. 

Trazodone: Classified as a serotonin antagonist and reuptake inhibitor (SARI), Trazodone can be used to treat depression, anxiety, or a combination of both. It is usually prescribed when other antidepressants have not worked, or have caused adverse side effects.

Amitriptyline: This tricyclic antidepressant, although older, remains effective. Tricyclic means it has three rings in its chemical structure. It is less commonly used today due to the number of side effects, but it can be more commonly prescribed for chronic pain.

Other antidepressants like paroxetine, selegiline, and vortioxetine are less commonly prescribed due to the established benefits and safety profiles of the medications listed above. However, they may still be prescribed for specific individuals or specialised cases where other antidepressants have not worked.

Understanding the Connection: Antidepressants and Sleep

Antidepressants can impact sleep patterns differently based on their type and individual responses. If you experience sleep disturbances or changes in your sleep patterns while taking antidepressants, it’s essential to speak to your GP. They can adjust your medication, recommend strategies to improve sleep hygiene, or suggest complementary treatments to help you achieve a good night’s sleep while effectively managing your mental health.

If you’re experiencing persistent sleep problems whilst taking antidepressants long term, you may benefit from a Cognitive Behavioural Therapy treatment like Sleepio. Cognitive Behavioural Therapy for Insomnia (CBT-I) is a highly effective and non-drug treatment option that addresses the root causes of insomnia and helps you regain control of your sleep.

Sleepio works with you to develop a personalised insomnia treatment plan, empowering you to challenge negative thought patterns, establish healthy sleep habits, and enjoy restful nights of sleep.

In summary, antidepressants play a vital role in mental health treatment, but their impact on sleep can vary widely. By understanding how different antidepressants affect sleep, you can work closely with your GP to find the most suitable medication and sleep management strategy to ensure that your mental health needs are met while also enabling you to have the restorative sleep that your body needs.