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Sleep disturbances and depression: a challenge for antidepressants

Lam, Raymond W.

International Clinical Psychopharmacology: February 2006 - Volume 21 - Issue - p S25-S29
doi: 10.1097/01.yic.0000195658.91524.61
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Sleep disturbances are commonly experienced by depressed patients, and abnormalities of sleep architecture are among the most robust psychobiological correlates of major depression. Most antidepressants alter the physiological patterns of sleep and eventually improve sleep symptoms, along with other symptoms of depression. However, many antidepressants also have unwanted adverse effects on sleep, notably by causing or worsening insomnia, daytime sleepiness or sedation. This article briefly reviews the biology of sleep, the sleep disturbances associated with depression, and the therapeutic and adverse effects of antidepressants on sleep. It also describes a novel antidepressant, agomelatine, which improves symptoms of depression and rapidly relieves sleep complaints without sedative effects.

Division of Clinical Neuroscience, Department of Psychiatry, University of British Columbia (UBC) and Mood Disorders Centre of Excellence, UBC Hospital, Vancouver, Canada

Correspondence and requests for reprints to Dr Raymond W. Lam, 2255 Wesbrook Mall, Vancouver V6T 2A1, Canada

Tel: +1 604 822 7325; fax: +1 604 822 7922;

e-mail: r.lam@ubc.ca

© 2006 Lippincott Williams & Wilkins, Inc.