May 12, 2008

Q^uestion

"Dear Dr. Adams:

"I have been on antidepressants. I sleep very poorly.  I had hoped that the medication would cure my sleep problem."

A^nswer

Dr. Adams replies:  "Almost three-quarters of patients with depression said they have insomnia, and 52% of them said they have actually been diagnosed with some type of sleep disturbance, making that the top diagnosis occurring with depression. In addition, 66% reported insomnia either started or persisted after they started the antidepressants. The top problems reported were difficulty falling asleep, difficulty staying asleep, and daytime drowsiness or fatigue, each of which was reported by about 45% of the respondents. In addition, sleeping too much was reported by 25%, and waking too early was reported by 31%.

Further, 38% said they had sleep disturbance that they attributed to their antidepressants. Of that group, 78% reported insomnia and 37% reported sedation.

Among patients with depression, there is a clear need to address sleep disturbance and to ensure sleep is not further perturbed by antidepressant treatment.

...it is common knowledge that weight gain and sexual dysfunction are major problems with antidepressants, but this study showed that many people on antidepressants also have sleep problems attributed to the antidepressants. It's common enough to where it probably reflects most classes of antidepressants.

A poll found that many patients are unwilling to tolerate those adverse effects. Asked if they would be willing to tolerate weight gain if an antidepressant were 100% effective in relieving their symptoms, 48% said they would not be willing at all. For sexual dysfunction, that rate was 29%, and for sleep disturbances it was 32%. For each of those adverse effects, over 50% were either not willing at all or only somewhat willing to tolerate the problem."