Side effects of antidepressants with a sedating effect
Antidepressants that have a sedating effect may include side effects such as:
- Dizziness and lightheadedness
- Prolonged drowsiness
- Dry mouth
- Irregular heartbeats
- Weight gain
- Daytime memory and performance problems
Prescription sleeping pills (and even some nonprescription sleeping pills) as well as certain antidepressants may not be safe if you are pregnant, breast-feeding or an older adult. Sleeping pill use may increase the risk of nighttime falls and injury in older adults. If you're an older adult, your doctor may prescribe a lower dose of medication to reduce your risk of problems.
Some health conditions — for example, kidney disease, high blood pressure or a history of seizures — may limit your options. Also, prescription drugs and over-the-counter sleep aids may interact with other medications. And taking certain prescription sleeping pills can lead to drug abuse or drug dependence, so it's important to follow your doctor's advice.
Taking sleeping pills
If your best attempts to get a good night's sleep have failed, prescription sleeping pills may be an option. Here's some advice on how to use them safely.
- Get a medical evaluation. Before you take sleeping pills, see your doctor for a thorough exam. Often your doctor may be able to find specific causes for your insomnia. In addition, if you're taking sleeping pills for more than a few weeks, talk to your doctor about an appropriate follow-up schedule to discuss your medications.
- Read the medication guide. Read the medication guide for patients so that you understand how and when to take your medication and what the major potential side effects are. If you have any questions, ask your pharmacist or your doctor.
- Never take a sleeping pill until you're going to bed. Sleeping pills can make you less aware of what you're doing, increasing the risk of dangerous situations. Wait to take your sleeping pill until you've completed all of your evening activities, about 15 minutes or less before you plan on sleeping.
- Plan to take your first sleeping pill when you can get a full night's sleep. Don't take a new sleeping pill the night before an important appointment or activity because you won't know how it affects you. Make sure you take a sleeping pill for the first time when you know you can get a full night's sleep, such as on a Friday night if you work weekdays. Generally, sleeping pills should be taken only when you know you can stay in bed seven to eight hours. A few short-acting sleeping pills are intended for middle of the night awakenings, so you may take them when you can stay in bed for 4 hours.
- Watch for side effects. If you feel sleepy or dizzy during the day or if you experience any other significant side effects, talk to your doctor about changing your dose or weaning off your pills.
- Avoid alcohol. Never mix alcohol and sleeping pills. Alcohol increases the sedative effects of the pills. Even a small amount of alcohol combined with sleeping pills can make you feel dizzy, confused or faint. And alcohol can actually cause insomnia.
- Never take sleeping pills longer than your doctor advises. Some prescription sleeping pills are for short-term use only — such as seven to 10 days. Be sure to contact your doctor for advice.
- Quit carefully. When you're ready to stop taking sleeping pills, follow your doctor's or pharmacist's instructions or the directions on the label. Some medications must be stopped gradually. Also, be aware that you may have some short-term rebound insomnia for a few days after you stop taking sleeping pills.
If you continue to have trouble sleeping, ask your doctor for additional help.
Dec. 27, 2014
See more In-depth
- Minkel J, et al. Optimizing the pharmacologic treatment of insomnia: Current status and future horizons. Sleep Medicine Clinics. 2013;8:333.
- Buysse DJ. Insomnia. JAMA. 2013;309:706.
- Gulyani S, et al. Sleep medicine pharmacotherapeutics overview: Today, tomorrow, and the future (Part 1: Insomnia and circadian rhythm disorders). Chest. 2012;142:1659.
- Roehrs T, et al. Insomnia pharmacotherapy. Neurotherapeutics. 2012;9:728.
- McCall C, et al. What is the role of sedating antidepressants, antipsychotics, and anticonvulsants in the management of insomnia? Current Psychiatry Reports. 2012;14:494.
- Halcion (prescribing information). New York, N.Y.: Pharmacia & Upjohn Co.; 2014. http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088610.pdf. Accessed Nov. 1, 2014.
- Lunesta (prescribing information). Marlborough, Mass.: Sunovion Pharmaceuticals Inc.; 2014. http://www.lunesta.com/pdf/lunesta-patient-medication-guide.pdf. Accessed Nov. 1, 2014.
- Rozerem (prescribing information). Deerfield, Ill.: Takeda Pharmaceuticals America Inc.; 2010. http://general.takedapharm.com/content/file.aspx?applicationcode=2bcc07ca-d9c0-4704-9a28-963127115641&filetypecode=rozerempi&cacheRandomizer=5eb4bdfd-285f-48a1-b99e-41ba6d9260d3. Accessed Nov. 1, 2014.
- Sonata (prescribing information). New York, N.Y.: King Pharmaceuticals Inc.; 2013. http://labeling.pfizer.com/ShowLabeling.aspx?id=710. Accessed Nov. 1, 2014.
- Ambien (prescribing information). Bridgewater, N.J.: Sanofi-Aventis; 2013. http://products.sanofi.us/ambien/ambien.pdf. Accessed Nov. 1, 2014.
- Estazolam (prescribing information). Corona, Calif.: Watson Laboratories Inc.; 2008. http://pi.actavis.com/data_stream.asp?product_group=1232&p=pi&language=E. Accessed Nov. 1, 2014.
- Restoril (prescribing information). Hazelwood, Mo.: Mallinckrodt Inc.; 2010. http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/018163s054lbl.pdf. Accessed Nov. 1, 2014.
- Pigeon WR, et al. Advances in the management of insomnia. F1000Prime Reports. 2014;6:48.
- Ambien CR (prescribing information). Bridgewater, N.J.: Sanofi-Aventis; 2013. http://products.sanofi.us/ambien_cr/ambiencr.html. Accessed Dec. 9, 2014.
- Neubauer DN. New and emerging pharmacotherapeutic approaches for insomnia. International Review of Psychiatry. 2014;26:214.
- Insomnia: Safe use of sleep aids. National Sleep Foundation. http://sleepfoundation.org/insomnia/content/safe-use-sleep-aids. Accessed Nov. 1, 2014.
- Krieger CA (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 20, 2014.
- Olson EJ (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 4, 2014.