Editing Insomnia (section)

==== Antidepressants ====
While insomnia is a common symptom of depression, [[antidepressant]]s are effective for treating sleep problems whether or not they are associated with depression. While all antidepressants help regulate sleep, some antidepressants, such as [[amitriptyline]], [[doxepin]], [[mirtazapine]], [[trazodone]], and [[trimipramine]], can have an immediate sedative effect and are prescribed to treat insomnia.<ref>{{cite journal | vauthors = Bertschy G, Ragama-Pardos E, Muscionico M, Aït-Ameur A, Roth L, Osiek C, Ferrero F | title = Trazodone addition for insomnia in venlafaxine-treated, depressed inpatients: a semi-naturalistic study | journal = Pharmacological Research | volume = 51 | issue = 1 | pages = 79–84 | date = January 2005 | pmid = 15519538 | doi = 10.1016/j.phrs.2004.06.007 }}</ref> Trazodone was at the beginning of the 2020s the biggest prescribed drug for sleep in the United States despite not being indicated for sleep.<ref name="Dunleavy">{{Cite web | vauthors = Dunleavy K |date=2023-04-07 |title=Idorsia petitions DEA to de-schedule its insomnia drug—plus Merck and Eisai rivals |url=https://www.fiercepharma.com/pharma/idorsia-petitions-dea-get-its-insomnia-drug-quviviq-and-others-dora-class-controlled |access-date=2023-08-31 |website=Fierce Pharma |archive-date=2023-08-31 |archive-url=https://web.archive.org/web/20230831190635/https://www.fiercepharma.com/pharma/idorsia-petitions-dea-get-its-insomnia-drug-quviviq-and-others-dora-class-controlled |url-status=live }}</ref>

Amitriptyline, doxepin, and trimipramine all have [[antihistaminergic]], [[anticholinergic]], [[antiadrenergic]], and [[antiserotonergic]] properties, which contribute to both their therapeutic effects and side effect profiles, while mirtazapine's actions are primarily antihistaminergic and antiserotonergic and trazodone's effects are primarily antiadrenergic and antiserotonergic. Mirtazapine is known to decrease sleep latency (i.e., the time it takes to fall asleep), promoting sleep efficiency and increasing the total amount of sleeping time in people with both depression and insomnia.<ref>{{cite journal | vauthors = Winokur A, DeMartinis NA, McNally DP, Gary EM, Cormier JL, Gary KA | title = Comparative effects of mirtazapine and fluoxetine on sleep physiology measures in patients with major depression and insomnia | journal = The Journal of Clinical Psychiatry | volume = 64 | issue = 10 | pages = 1224–29 | date = October 2003 | pmid = 14658972 | doi = 10.4088/JCP.v64n1013 }}</ref><ref>{{cite journal | vauthors = Schittecatte M, Dumont F, Machowski R, Cornil C, Lavergne F, Wilmotte J | s2cid = 25351993 | title = Effects of mirtazapine on sleep polygraphic variables in major depression | journal = Neuropsychobiology | volume = 46 | issue = 4 | pages = 197–201 | year = 2002 | pmid = 12566938 | doi = 10.1159/000067812 }}</ref>

[[Agomelatine]], a melatonergic antidepressant with claimed sleep-improving qualities that does not cause daytime drowsiness,<ref>{{cite journal | vauthors = Le Strat Y, Gorwood P | s2cid = 29745284 | title = Agomelatine, an innovative pharmacological response to unmet needs | journal = Journal of Psychopharmacology | volume = 22 | issue = 7 Suppl | pages = 4–8 | date = September 2008 | pmid = 18753276 | doi = 10.1177/0269881108092593 }}</ref> is approved for the treatment of depression though not sleep conditions in the European Union<ref name="emea">{{cite web |url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000915/WC500046227.pdf |title=Summary of Product Characteristics |publisher=European Medicine Agency |access-date=14 October 2013 |url-status=live |archive-url=https://web.archive.org/web/20141029015615/http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000915/WC500046227.pdf |archive-date=29 October 2014 }}</ref> and [[Australia]].<ref name="PI">{{cite web |title=VALDOXAN® Product Information |url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-07273-3 |work=TGA eBusiness Services |publisher=Servier Laboratories Pty Ltd |access-date=14 October 2013 |format=PDF |date=23 September 2013 |url-status=live |archive-url=https://web.archive.org/web/20170324132859/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-07273-3 |archive-date=24 March 2017 }}</ref> After trials in the United States, its development for use there was discontinued in October 2011<ref>{{cite web | url = http://www.scripintelligence.com/home/Novartis-drops-future-blockbuster-agomelatine-322880 | title = Novartis drops future blockbuster agomelatine. | archive-url = https://web.archive.org/web/20111111121308/http://www.scripintelligence.com/home/Novartis-drops-future-blockbuster-agomelatine-322880 | archive-date=11 November 2011 | work = Scrip Intelligence | date = 25 October 2011 | access-date = 30 October 2011 }}</ref> by [[Novartis]], who had bought the rights to market it there from the European pharmaceutical company [[Servier]].<ref name="Bentham">{{cite news |url=http://www.servier.co.uk/news/news-details.asp?StoryID=76 |title=Servier and Novartis sign licensing agreement for agomelatine, a novel treatment for depression | vauthors = Bentham C |date=29 March 2006 |publisher=Servier UK |access-date=15 May 2009 |archive-url=https://web.archive.org/web/20090416210513/http://www.servier.co.uk/news/news-details.asp?StoryID=76 |archive-date=16 April 2009 |url-status=dead }}</ref>

A 2018 [[Cochrane review]] found the safety of taking antidepressants for insomnia to be uncertain with no evidence supporting long term use.<ref>{{cite journal | vauthors = Everitt H, Baldwin DS, Stuart B, Lipinska G, Mayers A, Malizia AL, Manson CC, Wilson S | title = Antidepressants for insomnia in adults | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | pages = CD010753 | date = May 2018 | issue = 5 | pmid = 29761479 | pmc = 6494576 | doi = 10.1002/14651858.CD010753.pub2 }}</ref>