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    SSRIs for treating depression - Why they are not
    recommended in some cases
      
    Antidepressants are the most common type of drugs that are used in treating depression.
    Since insomnia is one of the most common symptoms of depression, these drugs are often
    used to elevate depressive moods and induce sleep.

    Among the various kinds of antidepressants, SSRI’s are among the latest that are now
    being used extensively for treating insomnia. Despite their rampant use, the efficacy of
    antidepressants like SSRIs to treat insomnia is not supported by clinical studies. Using
    SSRI’s to treat insomnia has also not been approved by the FDA.

    SSRIs are indicated mainly for clinical depression. This class of drugs should be used to
    treat insomnia only if it is one of the many symptoms of depression. However, primary care
    physicians tend to over-prescribe and suggest that SSRIs be used for insomnia to get
    quicker results.

    Different antidepressants have varying effects on depressive patients. An antidepressant is
    a drug that acts by blocking the reuptake of brain chemicals like norepinephrine and
    serotonin making more of those substances available to act on receptors in the brain. SSRIs
    act to maintain the level of serotonin (a neurotransmitter that is involved in sleep, memory
    and depression) by restricting its absorption.

    Some of the selective serotonin inhibitors are:

    * Fluoxetine (trade name Prozac)
    * Paroxetine (trade name Paxil)
    * Sertraline (trade name Zoloft)

    All antidepressants have side effects and SSRIs are no exception to the rule. SSRIs
    intake may produce side effects like:

    * Sleepiness
    * Headaches
    * Vivid dreams
    * Drowsiness
    * Nausea
    * Loss of sexual urge
    * Changes in appetite
    * Weight loss or gain
    * Liver or kidney damage

    SSRIs are also known to cause hypomania, a mood state characterized by lasting and
    permeating elated or irritable mood. They also cause thoughts and behaviors associated
    with such a mood on withdrawal. All classes of SSRIs therefore, must be tapered off
    gradually under professional guidance. Since SSRI’s also cause drowsiness, patients run
    the risk of bone fractures and injuries.

    SSRIs, like other antidepressants, require adequate dosage for a continuous period of four
    to eight weeks to take affect. In many cases the side effects may surface before the drug
    has had the desired effect on the depression of the patient. Treating depression naturally
    by means of psychotherapy coupled with antidepressants prove more effective in treating
    depression related insomnia than using either method as a standalone strategy.

    Natural remedies for depression are another safer option for treating insomnia. Herbs and
    herbal teas, homeopathy and relaxation techniques like meditation and breathing exercise
    are time tested remedies for treating all variants of insomnia including depression related
    insomnia.

    References:

    http://home.avvanta.com/~charlatn/depression/DepMeds.html#SSRI

    http://www.angelfire.com/home/bphoenix1/ads.html

    http://pn.psychiatryonline.org/cgi/content/full/40/17/30  



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