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Mirtazapine, sold under the brand name Remeron among others, is an atypical tetracyclic antidepressant, and as such is used primarily to treat depression. [11] [12] Its effects may take up to four weeks but can also manifest as early as one to two weeks. [12] [13] It is often used in cases of depression complicated by anxiety or insomnia.
Trazodone, sold under many brand names, [1] is an antidepressant medication [20] used to treat major depressive disorder, anxiety disorders, and insomnia. [20] It is a phenylpiperazine compound of the serotonin antagonist and reuptake inhibitor (SARI) class.
Abilify (aripiprazole) – atypical antipsychotic used to treat schizophrenia, bipolar disorder, and irritability associated with autism; Adderall (mixed amphetamine salts) – a stimulant used to treat ADHD; Ambien – nonbenzodiazepine used as a sleep aid; Anafranil (clomipramine) – a tricyclic antidepressant; mostly used to treat OCD
A 2012 meta-analysis concluded that antidepressant treatment favorably affects pain, health-related quality of life, depression, and sleep in fibromyalgia syndrome. Tricyclics appear to be the most effective class, with moderate effects on pain and sleep, and small effects on fatigue and health-related quality of life.
Chemically, it is a secondary amine dibenzocycloheptene and pharmacologically it is classed as a first-generation antidepressant. [36] Nortriptyline may also have a sleep-improving effect due to antagonism of the H 1 and 5-HT 2A receptors. [37] In the short term, however, nortriptyline may disturb sleep due to its activating effect.
Blockade of the H 1 receptor is responsible for the sedative effects of trimipramine and other TCAs and their effectiveness in the treatment of insomnia. [41] Most antidepressants suppress REM sleep, in parallel with their alleviation of depressive symptoms (although suppression of REM sleep is not required for antidepressant effects). [6]
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