How does effexor effect sleep

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What are the signs and symptoms of hidradenitis suppurativa? What is reflexology? Wilson's disease Wilson's syndrome: An accepted medical diagnosis? The main indications for the effects of Effexor are depression, and general anxiety. Depressive symptoms treated by Effexor include : depressed mood, decreased sense of pleasure, quick changes of weight and apetitite, and sleep disturbances. The anxiety symptoms treated by Effexor include : intense fears and worries, and at least three of the the following six symptoms: restelessness or feelings of rage, fatigue, difficulties with concentration, mind going blank, irritablity, muscle tention, and of course, sleep problems.

After the course of Effexor or Effexor XR extended release , depression reduces and anxiety decreases. Moreover, although antidepressants are recommended for the treatment of post-traumatic sleep disorder, they can induce nightmares. We observe this side effect most frequently during the treatment with mirtazapine, just as it was recently reported [ 31 ].

Finally, antidepressants inducing weight gain are contraindicated in patients with sleep apnea, that is an overlooked but frequent sleep disorder in people suffering from mental illness [ 32 ]. Insomnia belongs to the most frequent disorders of the brain [ 33 ]. Although insomnia is not regarded as a severe mental disorder, it shares many features with depression. In order to offer a patient an effective treatment of insomnia, there is a need for a broader perspective, one that reaches far beyond the prescription of hypnotics.

However, in daily clinical practice, the use of pharmacotherapy for insomnia is very common. However, due to the lack of methodologically sound randomized clinical trials in insomnia, only one of them, doxepin, is approved by FDA for the treatment of sleep maintenance insomnia. In our opinion, sedative antidepressants are a valuable treatment option of insomnia in a situation in which despite being in CBT-I therapy, the patient still requires sleep-promoting drugs more than 3—4 times per week.

The use of sedative antidepressants should be also considered when there is a comorbid mood or anxiety disorder because such patients are at increased risk of developing hypnotic dependency. Moreover, in many insomnia patients, physiological parameters, e. The pros and cons of using sedative antidepressants in insomnia patients were discussed extensively in the earlier papers.

This is especially true for trazodone that is very often used as a sleep-promoting drug [ 3 , 39 — 42 ]. Frequently expressed concern with the usage of sedative antidepressants in insomnia is that their side effect profile and interactions with other drugs may be underrated [ 40 ].

Many psychiatrists are astonished that a sedative antidepressant can promote sleep in such a low dose. Firstly, it should be noted that such low doses are appropriate only for patients with primary insomnia.

In the presence of a comorbid mood disorder, the antidepressants have to be used in a recommended therapeutic dose [ 42 ]. Secondly, such treatment should be used only when combined with behavioral interventions from CBT-I protocol. When a patient restricts time in bed and uses stimulus control technique, even low-dosage pharmacological treatment starts to work.

Thirdly, to be effective in treating sleep-onset insomnia, sedative antidepressants have to be taken much earlier than hypnotics in regard to their pharmacokinetics, especially the time they take to reach the maximum serum concentration Cmax. It usually means at least 2 hours before sleep in the case of more rapid drug action the patient should be encouraged to shorten this time.

In our opinion, sedative antidepressants are a safe class of drugs when given in low doses. We use them in many patient groups where hypnotics are contraindicated, e. Despite the fact that the use of atypical antipsychotics, mostly quetiapine [ 44 ], is increasing for treatment of insomnia accompanying bipolar disorder and schizophrenia, we hold the conviction that sedative antidepressants are a valuable treatment option for such patients as well.

Based on our clinical experience and review of published case reports, we believe that the use of sedative antidepressants in a low dose is not related to the increased risk of phase shift in bipolar disorder [ 45 ]. Moreover, we have observed that for the treatment of insomnia low doses 5—10 mg of citalopram administered in the morning can be an alternative to sedative antidepressants with good treatment effects [ 46 ].

Disturbed sleep is a core symptom of depression and its normalization is necessary to achieve remission from the illness. In the long term, all antidepressants which show clinical efficacy improve sleep secondary to improvement of mood and daytime activity. However, in the short term, while some of them may impair sleep due to the activating effects, other may improve sleep due to the sedative properties. Although sleep-promoting action is desired in depressed patients with coexisting anxiety or insomnia, it may be problematic during the maintenance treatment after recovery from depression due to oversedation.

Thus, it is necessary to understand the effects of these drugs on the sleep and daytime alertness. It is particularly noteworthy that for sleep-promoting effect, it is sufficient to use a sedative antidepressant in a low dose. In such dose, these drugs can be also combined with other antidepressants as an alternative to hypnotic drugs, especially if there is a clinical necessity to promote sleep for longer than 2—4 weeks with a frequency higher than 3—4 times per week.

This article does not contain any studies with human or animal subjects performed by any of the authors. This article is part of the Topical Collection on Sleep Disorders. National Center for Biotechnology Information , U. Current Psychiatry Reports. Curr Psychiatry Rep. Published online Aug 9. Author information Copyright and License information Disclaimer. Corresponding author. This article has been cited by other articles in PMC. Abstract Purpose of Review The aim of this review article was to summarize recent publications on effects of antidepressants on sleep and to show that these effects not only depend on the kind of antidepressant drugs but are also related to the dose, the time of drug administration, and the duration of the treatment.

Recent Findings Complaints of disrupted sleep are very common in patients suffering from depression, and they are listed among diagnostic criteria for this disorder. Summary For successful treatment of depression, it is necessary to understand the effects of antidepressants on sleep. Keywords: Depression, Sleep, Antidepressants, Insomnia. Introduction Depression is a severe and common mental disorder with month prevalence as high as 3.

Polysomnographic Sleep Studies in Depression The most detailed information on sleep in depression was provided by studies using polysomnography PSG , that is considered the gold standard for sleep assessment.

Table 1 Definitions of sleep parameters based on scoring of sleep stages in polysomnographic recording, and used to describe the sleep architecture. Normal values are typically below 30 min in young and below 45 min in elderly patients.

Total sleep time TST The total time spent asleep during the sleep episode. This is equal to the time in bed less the awake time. In insomnia research as shortened sleep time are considered usually values below 6. Typically WASO should not exceed 30 min.

Delta sleep ratio The ratio of slow wave sleep in the first and second sleep cycle. Normally, values exceed 1. Reduced values are typically below 65 min in young and 50 min. REM density The ratio of the intensity of rapid eye movements phasic activity number and duration of rapid eye movements to duration of REM sleep, e. Open in a separate window. Table 2 Effects of antidepressants on sleep. Treatment of Insomnia Disorder with Low-Dose Antidepressants Insomnia belongs to the most frequent disorders of the brain [ 33 ].

Conclusions Disturbed sleep is a core symptom of depression and its normalization is necessary to achieve remission from the illness. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.

Depression, chronic diseases, and decrements in health: results from the world health surveys. Greden JF. Unmet need: what justifies the search for a new antidepressant? J Clin Psychiatry. Sleep and antidepressant treatment. Curr Pharm Des. Le Bon O. Contribution of sleep research to the development of new antidepressants.