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New Antidepressant
Also Helps You Sleep
Remeron Acts Quickly to Help You Go to Sleep
Faster, Sleep Longer |
By Amy Rothman Schonfeld, PhD
WebMD Medical News
Reviewed by Dr. Jacqueline Brooks
Many patients with severe depression complain of
trouble sleeping, but some of the medications used
to treat depression may sometimes actually add to
their sleep problems. However, Remeron (mirtazapine),
a relatively new antidepressant, may prove be particularly
useful for these people, because it quickly alleviates
depression and also helps them sleep better.
Many physicians have noticed that Remeron affects
sleep, says Andrew Winokur, MD, PhD, lead author
of a new study that explored Remeron's effects on
sleep. Depressed patients have reported that they
sleep longer or heavier when they are taking it.
On the down side, some of these patients have reported
they feel sleepy during the daytime while on Remeron.
"Other [researchers] have estimated that 80%
of patients with depression experience problems
with sleep ... Our findings could give important
practical information for [doctors] who might want
to know which drugs would have the best combination
of both antidepressant effects and also help sleep,"
says Winokur, of the University of Connecticut Health
Center in Farmington.
In their report in the July 1 issue of the journal
Biological Psychiatry, Winokur and his colleagues
evaluated the effect of Remeron on patients' sleep
by studying their sleep in a sleep laboratory. Six
patients who were diagnosed with severe depression
and complained of sleep problems were selected.
The sleep-inducing effects of Remeron could be seen
within the first week of treatment. Time taken to
fall asleep decreased from about 15 minutes to five
minutes. Total sleep time increased by about an
hour a night -- from six hours to seven hours. The
amount of time the participants spent actually sleeping
compared to the amount of time just spent in bed
also increased, from about 83% to 93%.
"I think this study clearly showed [Remeron]
is a medication that is useful in promoting sleep
in patients with depression," says Eric Nofzinger,
MD, a psychiatrist affiliated with the Clinical
Neuroscience research Center at the University of
Pittsburgh Medical Center in Pennsylvania. "That's
a very useful feature because a number of patients
with depression have difficulties in initiating
sleep and staying asleep."
According to Winokur, these sleep-enhancing effects
from Remeron are greater than those usually seen
from most other antidepressants. The results are
more similar to those seen in sleeping pills and
other medications designed specifically to help
sleep. Four of the six patients reported initial
daytime sleepiness. "Generally, they acclimated
to it within a couple of weeks, if not sooner ...
It was a temporary, mild inconvenience," Winokur
tells WebMD.
Noticeable antidepressant effects were seen at
the same time that sleep was improving, says Winokur.Winokur
says that one problem with the study was the small
number of patients tested and that further testing
is needed on a larger number of patients. Also,
the patients knew they were taking the medicine
and no control group was tested with dummy tablets
for comparison, which may have altered the results.
"There are a number of antidepressants that
don't necessarily improve sleep on their own, such
as most of the commonly used" antidepressants
called SSRIs, including Prozac, says Nofzinger.
He says that patients on these medications may report
sleep improvement once their depression is under
control.
Remeron's advantage appears to be its more rapid
effect. More standard antidepressants may require
four to 12 weeks before taking effect, says Nofzinger.
"I would tell patients that this is certainly
one approach that could be very effective in helping
both sleep complaints and depressive symptoms."
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