Do antidepressants make you tired
Pro Research Analysisby 
Searched over 200M research papers
Do Antidepressants Make You Tired?
Antidepressants are commonly prescribed to treat major depressive disorder (MDD) and other mood disorders. However, their impact on sleep and fatigue is a significant concern for many patients. This article explores the relationship between antidepressants and tiredness, drawing on multiple research studies.
Antidepressants and Sleep Patterns
Alteration of Sleep Stages
Most antidepressants affect sleep by altering the physiological patterns of sleep stages. These changes are most pronounced in rapid eye movement (REM) sleep. Antidepressants that increase serotonin function, such as selective serotonin reuptake inhibitors (SSRIs), tend to reduce the amount of REM sleep and increase the latency to REM sleep onset 16. These effects are more significant early in treatment and tend to diminish over time, except in the case of monoamine oxidase inhibitors (MAOIs), where REM sleep can be absent for months .
Sleep Initiation and Maintenance
The impact of antidepressants on sleep initiation and maintenance varies between different drugs. Some antidepressants, like clomipramine and fluoxetine, can disturb sleep early in treatment, while others, such as amitriptyline and serotonin 5-HT2-receptor antagonists, promote sleep 16. However, these effects are generally short-lived, and significant differences between drugs tend to disappear after a few weeks of treatment .
Fatigue and Daytime Sleepiness
Prevalence of Fatigue
Fatigue and sleepiness are common side effects reported by patients on long-term antidepressant therapy. Over 40% of patients report experiencing fatigue and sleepiness, which are likely both side effects of the medication and residual symptoms of depression . These symptoms can significantly impact daily functioning and quality of life.
Sedating vs. Activating Antidepressants
The type of antidepressant plays a crucial role in whether a patient experiences fatigue or increased energy. Sedating antidepressants, such as mirtazapine, doxepin, and trazodone, can improve sleep but may cause oversedation in the long term . Conversely, activating antidepressants like fluoxetine and venlafaxine may disrupt sleep initially but are less likely to cause daytime sleepiness 49.
Therapeutic Interventions
In some cases, adjunct therapies like modafinil have been used to manage residual fatigue and sleepiness in patients who are partial responders to antidepressant therapy. Modafinil has shown promise in improving wakefulness and reducing fatigue, although its long-term efficacy remains uncertain .
Conclusion
Antidepressants can indeed make you tired, but the extent and nature of this tiredness depend on the specific medication, its dosage, and the duration of treatment. While some antidepressants may initially disrupt sleep or cause sedation, these effects often diminish over time. Patients experiencing significant fatigue or sleepiness should consult their healthcare provider to adjust their treatment plan, which may include switching medications or adding adjunct therapies like modafinil. Understanding the complex relationship between antidepressants and sleep can help optimize treatment and improve patient outcomes.
Sources and full results
Most relevant research papers on this topic