Drugs used to treat psychiatric disorders

Antidepressants such as tricyclics, monoamine oxidase inhibitors, and others (trazodone, fluoxetine, bupropion, ritenserin, and lithium) may cause sleep disruption, alter sleep architecture, and suppress REM sleep. Sedative antidepressants (e.g. amitryptiline (Elavil (@)), doxepin, and trazodone) may be used to treat insomnia, especially if associated with depression. Most tricyclic antidepressants may cause daytime sedation. Monoamine oxidase inhibitors have alerting properties and so they should be used preferably in the morning or early afternoon. Trazodone, a sedative antidepressant, increases SWS but is a weak REM suppressant. Fluoxetine has an alerting effect and can suppress REM sleep at high doses. Lithium increases SWS and has a mild REM suppressant effect. Sudden withdrawal of these REM-suppressant medications may cause REM rebound.

Neuroleptics such as haloperidol, phenothiazines, and thioridazine are used to treat schizophrenia and other psychotic conditions. Some of these drugs, particularly phenothiazines, may cause drowsiness and impairment of performance. All neuroleptics may produce serious side-effects in combination with hypnotics, alcohol, or antihistaminic agents.

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