Antidepressants and Sleep: What You Should Know

Erica Bronen

It is well known that several antidepressant medicines can impair sleep quality, owing to increased noradrenergic and dopaminergic neurotransmission and activation of serotonergic 5-HT2 receptors. Serotonin and Norepinephrine Reuptake Inhibitors (SNRI), Norepinephrine Reuptake Inhibitors (NRI), Monoamine Oxidase Inhibitors (MAOI), Selective Serotonin Reuptake Inhibitors (SSRI), and activating Tricyclic Antidepressants (TCA) are the most well-known among them. Antidepressants with antihistaminergic effect, such as sedating TCA, mirtazapine, and mianserine, or antidepressants with strong antagonistic action at serotonergic 5-HT2 receptors, such as trazodone and nefazodone, on the other hand, enhance sleep swiftly. Some patients report improved sleep quality after just one dose of mirtazapine, which has been linked to a faster onset of antidepressant activity in mirtazapine.