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Research project: Antidepressants for Insomnia: Cochrane systematic review

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Why is this review important? Insomnia is common, approximately one in five people report sleep problems in the last year.

NEW Publication 14 May 2018

Insomnia can cause daytime fatigue, distress, impairment of daytime functioning and reduced quality of life. It is associated with increased mental health problems, drug and alcohol abuse and increased health care use. Management depends on the duration and nature of the sleep problem. It may involve: treating existing co-existing medical problems; providing advice on sleep habits and lifestyle (known as sleep hygiene); medications and psychological therapies such as cognitive behavioural therapy (CBT).

’Hypnotics’ (e.g. temazepam and ’Z’ drugs) are the most common medications used to treat insomnia and are known to help sleep but can have problems such as tolerance and dependence. Guidelines recommend only short-term use of hypnotics (2 to 4 weeks). However, millions of people worldwide are on long-term hypnotic medication.

Antidepressants are widely prescribed for insomnia despite not being licenced for this use and uncertain evidence for their effectiveness. This may be because of the concerns regarding hypnotic medications. Psychological treatments are known to help insomnia but availability is limited. Thus alternative medications such as antidepressants and antihistamines are sometimes tried. Assessing the evidence for the unlicensed use of these medications is important.

Who will be interested in this review?

People with sleep problems and their doctors will be interested in this review to better understand the research evidence and enable informed decision-making regarding taking antidepressants for insomnia.

What questions does this review aim to answer?

The aim was to look systematically at the evidence for antidepressants for insomnia in adults (how well they work, their safety and tolerability (any reported side effects)).

Partially funded by a small grant from the NIHR School for Primary Care Research

Contact: Hazel Everitt



Related research groups

Primary Care, Population Sciences and Medical Education


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