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Sedating antidepressant

Whom it may be suitable for: Those with milder or chronic cases of depression, because it has fewer side effects.

Pros: This norepinephrine dopamine reuptake inhibitor (NDRI) is often added on to other antidepressant treatments that lose effectiveness over time or cause sexual dysfunction.

Both eszopiclone and sustained-release zolpidem are effective for both sleep-onset and sleep-maintenance insomnia, with a reduced abuse potential and long-term efficacy of up to 6 months as compared with nonselective benzodiazepine receptor agonists.

Short-acting (eg, triazolam) and intermediate-acting (eg, estazolam, temazepam) benzodiazepine receptor agonists are useful for sleep-onset insomnia.

Other complications of benzodiazepine use include tolerance, withdrawal, abuse, and rebound insomnia.

Selective melatonin agonists are indicated for insomnia characterized by difficulty with sleep onset, particularly for individuals who lack dim-light melatonin-onset stimulation.

Whom it may be suitable for: Can be ideal for the elderly because of fewer side effects when prescribed at lower doses.

Pros: A very effective SSRI that can be easier to start and stay on than others.Side effects: Jitteriness, insomnia, headaches, dry mouth, nausea (and, rarely, risk of seizure).Whom it may be suitable for: Not an ideal first-line treatment: Start-up can be difficult to tolerate, and serotonin is often needed to effect mood change.This article was originally titled "The pros and cons of some popular antidepressants," in the September 2008 issue of Best Health Magazine. Medications used in the treatment of insomnia include nonbenzodiazepine receptor agonists, benzodiazepine receptor agonists, the selective melatonin receptor agonist ramelteon, and sedating antidepressants.Side effects: Nausea, insomnia, headaches, sexual dysfunction, jitteriness; possibly drowsiness, dry mouth, constipation.It’s the worst one for weight gain, and among the worst for withdrawal symptoms (unless properly managed).Pros: This SSRI has fewer overall side effects than some antidepressants, but the serotonin-related side effects can be powerful.Side effects: Nausea, insomnia, headaches, sexual dysfunction, jitteriness, dry mouth, drowsiness.Whom it may be suitable for: Those whose depression causes fatigue; also ideal for anxiety symptoms and anxiety disorders; not ideal where weight gain is a health concern.Pros: Some find this SSRI has the fewest side effects.

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