Sleep Drug during Depression Treatment can Solve Insomnia Symptoms

Insomnia and depression are often closely related. The relationship can go both ways: depression can cause insomnia, and insomnia can lead to depression.

Depression drugs are the front-line treatment for most patients, but as the bleakness of depression goes away the sleeplessness often stays.

A team of researchers say the insomnia can be easily solved by altering patients’ prescriptions. They found that pairing the hypnotic sleeping pill Lunesta with serotonin reuptake inhibitors (SSRI) may be the ideal approach for depression with insomnia.

The study involved 60 patients diagnosed with depression and insomnia. After one week of taking Prozac, the subjects began combining the drug with Lunesta or a placebo.

Patients who took the sleeping drugs reported a higher health-related quality of life. Depression improved and the patients had less difficulty sleeping.


The AASM reports that insomnia can occur in 85 percent of people with a major depressive episode. Frequent awakenings during the night are typical; waking up early in the morning and being unable to go back to sleep also is common.

Often the insomnia complaint is among the earliest symptoms to appear in a person with a mental health disorder. People often attribute their mental symptoms to poor sleep.

Photo by Max Talbot-Minkin

An Economic Upturn for Makers of Sleeping Pills

Another sign that the economy is affecting our sleep: We’re taking more sleeping pills.

Advertising Age reports that sleeping-pill prescriptions increased seven percent last year. Sales rose even though ad spending dropped by hundreds of millions of dollars.

Sepracor had revenues of $161.9 million for the fourth quarter of 2008 from sales of Lunesta. This was up from $149.8 million for the same quarter in 2007. Full-year revenues were a little more than $600 million in both 2007 and 2008.

But sales aren’t up across the board.

Fourth-quarter net sales of Ambien CR (controlled release) in the U.S. were $170 million for sanofi-aventis. This was down from $190 million in the same quarter of 2007. Full-year sales dropped from $751 million in 2007 to $681 million in 2008.

Full-year net sales for Ambien IR (immediate release) fell to $125 million in 2008. The sanofi-aventis patent for this drug expired in April 2007. Many other companies then received FDA approval to sell less expensive, generic versions of Ambien.

The Boston Globe points out two other reasons why prescriptions may be up.

One reason has to do with safety. Older types of sleeping pills were limited to short-term use for one or two weeks. There was a risk that long-term use could cause addiction. There also was a risk that your body would develop a tolerance to the drug.

But sleeping pills introduced in the last two decades are considered to be safer. Ambien CR, Lunesta and Rozerem all have been approved for long-term use.

A study in the journal Sleep in 2008 found that regular use of Ambien CR for six months is safe and effective. The study was funded by sanofi-aventis.

In 2007 a study in the journal Sleep confirmed the long-term effectiveness of Lunesta. A nightly dose of 3 mg remained effective after six months. The study was funded by Sepracor.

A study in the Journal of Clinical Sleep Medicine in 2007 showed that nightly use of Rozerem was safe and effective over five weeks. The study was funded by Takeda.

The Globe also reports that more doctors are taking insomnia seriously. They recognize that treatment can promote both physical and mental health.

In 2008 a study in the journal Sleep affirmed that primary insomnia is a legitimate disorder. It linked primary insomnia to low levels of the brain chemical GABA. Many of the most effective sleeping pills increase brain activity at the GABA neurons. The study was funded in part by Sepracor.

Read the Guidelines for Taking Sleep Medications from the AASM.