Treatment of insomnia associated with clinical depression.
Sleep disturbances are almost always present in patients with depression. Though sleep disturbances generally abate with the resolution of depression, some patients continue to report poor sleep. Since a number of studies have demonstrated that insomnia increases the risk of new-onset depression and recurrence of depression, optimal management of insomnia associated with depression becomes an important clinical goal. Antidepressant agents have variable effects on sleep and in fact, some antidepressants seem to worsen sleep in patients with depression. This article reviews various treatment options in the management of patients presenting with insomnia and depression, including single agents, combination strategies and behavioral interventions.
Jindal
Ripu D
RD
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. jindalr@msx.upmc.edu
Thase
Michael E
ME
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D004359:Drug Therapy, Combination; D018756:GABA Antagonists / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D017286:Polysomnography / Q000379:methods; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012895:Sleep, REM / Q000502:physiology
D000929:Antidepressive Agents, Tricyclic; D018756:GABA Antagonists; D001569:Benzodiazepines