Do sertraline make you sleepy
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Does Sertraline Make You Sleepy?
Introduction to Sertraline and Sleep
Sertraline, a selective serotonin reuptake inhibitor (SSRI), is commonly prescribed for depression and anxiety disorders. While SSRIs are known to affect sleep patterns, the specific impact of sertraline on sleepiness and sleep architecture is a subject of ongoing research.
Sertraline's Impact on Sleep Architecture
Studies have shown that sertraline can alter sleep architecture in various ways. For instance, sertraline has been found to increase delta wave sleep in the first sleep cycle and prolong rapid eye movement (REM) sleep latency. However, it also decreases the average number of REM periods, although the activity of the initial REM periods is increased1. Despite these changes, sertraline does not significantly worsen measures of sleep continuity or subjective sleepiness1.
Periodic Limb Movements and Sleep Disturbances
Sertraline has been associated with an increase in periodic limb movements during sleep (PLMS). In an 8-week study, patients treated with sertraline showed a significant increase in PLMS indices, which stabilized after the initial weeks of treatment. Although these movements were more frequent, they did not cause significant clinical disturbances2. This suggests that while sertraline can lead to more frequent nocturnal arousals, it may not necessarily result in increased daytime sleepiness.
Case Reports and Subjective Sleepiness
There are isolated reports of sertraline causing significant drowsiness and confusion, as evidenced by a case where a sertraline-intoxicated driver exhibited symptoms such as mumbled speech, droopy eyes, and an inability to stand or walk3. However, such extreme cases are rare and often involve unusually high doses or individual sensitivity to the drug.
Comparative Studies with Other Antidepressants
Comparative studies have shown that sertraline has a less detrimental effect on psychomotor performance and subjective drowsiness compared to other antidepressants like amitriptyline. While both drugs can cause subjective drowsiness, amitriptyline's sedative effects are more pronounced and longer-lasting6. This indicates that sertraline may have a slight activating effect, which could counteract feelings of sleepiness.
Common Side Effects and Insomnia
Common side effects of sertraline include nausea, insomnia, diarrhea, somnolence, and dizziness5. Insomnia and somnolence are particularly relevant to the discussion of sleepiness. While some patients may experience increased sleepiness, others might suffer from insomnia, highlighting the variable effects of sertraline on sleep.
Conclusion
In summary, sertraline can affect sleep architecture by increasing delta wave sleep and prolonging REM sleep latency, but it does not significantly worsen sleep continuity or subjective sleepiness1. It can also increase periodic limb movements during sleep without causing significant clinical disturbances2. While there are rare cases of extreme drowsiness, sertraline generally has a less sedative effect compared to other antidepressants like amitriptyline6. Therefore, while sertraline may cause sleepiness in some individuals, it is not a universal side effect and varies based on individual response and dosage.
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Most relevant research papers on this topic
Effects of Sertraline on Sleep Architecture in Patients With Depression
Sertraline therapy increases delta wave sleep and prolongs REM sleep latency in depressed patients, but does not worsen sleep continuity or subjective sleepiness.
RCT
Highly CitedSertraline and periodic limb movements during sleep: an 8-week open-label study in depressed patients with insomnia.
Sertraline treatment increased periodic limb movements during sleep, but its effect may be dosage-dependent, and it may cause higher arousal levels in depressed patients with insomnia.
Non-RCTA sertraline-intoxicated driver.
Sertraline use can cause confusion, sleepiness, and droopy eyes, making it a potential cause of driving under the influence in cases where alcohol is not present.
Case ReportDouble-blind, multicenter comparative study of sertraline and amitriptyline in hospitalized patients with major depression.
Sertraline shows no significant difference in efficacy compared to amitriptyline in hospitalized patients with major depression, but has a significantly better safety profile.
RCTSinus Arrest due to Sertraline
Sertraline may cause sinus arrest when switched from citalopram to sertraline, causing nausea, dizziness, and insomnia in a patient with prior adverse reactions.
Case ReportAcute effects of sertraline, amitriptyline, and placebo on the psychomotor performance of healthy subjects over 50 years of age.
Sertraline has a less detrimental effect on psychomotor performance and may have a slight activating effect compared to amitriptyline, with both drugs causing drowsiness and potentially increasing blood pressure.
RCTCognitive behavioral therapy, sertraline, or a combination in childhood anxiety.
Combination therapy of cognitive behavioral therapy and sertraline is more effective than either therapy alone in reducing anxiety severity in children with anxiety disorders.
RCT
Large Human TrialHighly CitedEffect of sertraline on symptoms and survival in patients with advanced cancer, but without major depression: a placebo-controlled double-blind randomised trial.
Sertraline showed no significant effect on depression, anxiety, fatigue, or overall quality of life in advanced cancer patients without major depression.
RCTHighly CitedSertraline and rapid eye movement sleep without atonia: An 8-week, open-label study of depressed patients
Sertraline may induce or exacerbate rapid eye movement sleep without atonia in depressed patients, suggesting a potential public health issue.
Non-RCTAn open study of the effects of sertraline on adolescent major depression.
Sertraline may be useful in treating adolescents with major depression, with common adverse effects including insomnia and drowsiness, but usually manageable.
Non-RCT