Depending on your heart health and the type of antidepressant you take, periodically you may need an electrocardiogram (ECG) to monitor what's called the QT interval to be sure there is no prolonged interval before or during treatment that could increase your risk of serious irregular heart rhythms (arrhythmia).If side effects seem intolerable, you may be tempted to stop taking an antidepressant or to reduce your dose on your own. Your symptoms may return, and stopping your antidepressant suddenly may cause withdrawal-like symptoms.Antidepressants There is limited evidence for efficacy of antidepressants in insomnia.
If any uncertainty exists about the diagnosis or if any safety concerns have been identified (eg, excessive daytime sleepiness or parasomnias causing injuries), patient referral for an assessment by a sleep specialist is indicated.
One study found that behavioural treatment for insomnia, consisting of individualised behavioural instructions delivered in two intervention sessions and two telephone calls, provided a simple, effective and durable intervention for chronic insomnia in older adults.
However, there have been few large studies demonstrating the efficacy and safety of most off-label medications prescribed to treat insomnia.
In addition, many of these medications have significant known side effect profiles themselves.
In some cases, however, antidepressants cause side effects that don't go away.
Talk to your doctor or mental health provider about any side effects you're having.
There are no controlled studies for the use of low-dose amitriptyline for insomnia, but it is widely used in this way in primary care.
Antipsychotics In the past, sedative antipsychotics were used for insomnia, but concerns over their cardiac safety prevents their use.
There are a number of antidepressants available that work in slightly different ways and have different side effects.