Does 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 other mood disorders. One of the concerns patients often have is whether sertraline can cause sleepiness or other sleep-related issues. This article synthesizes findings from multiple studies to address this question.
Sertraline's Impact on Sleep Architecture
Changes in Sleep Patterns
Research indicates that sertraline affects sleep architecture in several ways. A study involving 47 patients with major depressive disorder found that sertraline increased delta wave sleep in the first sleep cycle and prolonged rapid eye movement (REM) sleep latency. However, it also decreased the average number of REM periods . Despite these changes, sertraline did not significantly worsen measures of sleep continuity or subjective sleepiness compared to a placebo .
Periodic Limb Movements and Arousal
Another study focused on sertraline's impact on periodic limb movements during sleep (PLMS) in depressed patients with insomnia. The study found that sertraline increased PLMS indices, which were associated with a higher arousal index (AI). However, these movements did not cause significant clinical disturbances . This suggests that while sertraline may lead to more frequent arousals, it does not necessarily translate to increased sleepiness during the day.
Comparative Studies with Other Antidepressants
Sertraline vs. Agomelatine
A comparative study between sertraline and agomelatine, another antidepressant, found that agomelatine had a more favorable impact on sleep latency and sleep efficiency. Patients on agomelatine showed significant improvements in these areas compared to those on sertraline . This indicates that while sertraline may not be the best option for improving sleep efficiency, it does not necessarily cause excessive sleepiness.
Sertraline vs. Amitriptyline
In a study comparing sertraline with amitriptyline, a tricyclic antidepressant known for its sedative properties, sertraline was found to be less effective in addressing sleep disturbances. Amitriptyline's sedative effects were more pronounced, making it more effective for sleep-related issues . This further supports the notion that sertraline is less likely to cause significant sleepiness compared to other antidepressants with sedative properties.
Case Reports and Adverse Effects
Sertraline Intoxication
A case report documented an instance of a driver under the influence of sertraline who exhibited symptoms such as confusion, inability to stand or walk, and sleepiness . While this is an extreme case, it highlights that high doses or individual sensitivity to sertraline can lead to significant drowsiness.
Common Adverse Effects
Common adverse effects of sertraline include nausea, insomnia, diarrhea, somnolence, and dizziness . While somnolence (sleepiness) is listed as a potential side effect, it is not universally experienced by all patients.
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 cause excessive daytime sleepiness in most patients 12. Comparative studies suggest that sertraline is less sedative than other antidepressants like amitriptyline . However, individual responses can vary, and some patients may experience sleepiness, particularly at higher doses 56. Clinicians should monitor patients for sleep-related side effects and adjust treatment as necessary.
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