From the Research
Selective Serotonin Reuptake Inhibitors (SSRIs) are not typically first-line treatments for insomnia, but may be prescribed when insomnia co-occurs with depression or anxiety, with paroxetine showing significant improvements in subjective sleep measures at six and 12 weeks, as seen in a study published in 2018 1. When using SSRIs to combat insomnia, common options include fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), and paroxetine (Paxil).
- Treatment usually begins with a low dose taken in the morning, such as 10mg of fluoxetine, 25mg of sertraline, 5mg of escitalopram, or 10mg of paroxetine, with gradual increases if needed.
- SSRIs work by increasing serotonin levels in the brain, which can help regulate mood and potentially improve sleep patterns, though they may initially worsen insomnia as a side effect.
- It typically takes 2-4 weeks to see improvement in sleep quality, as noted in various studies, including one from 2019 2. Patients should maintain good sleep hygiene practices alongside medication, including:
- Consistent sleep schedules
- Limiting screen time before bed
- Avoiding caffeine and alcohol
- Creating a comfortable sleep environment If insomnia persists after 4-6 weeks of SSRI treatment, consultation with a healthcare provider is recommended to adjust the treatment plan, considering the findings of a systematic review published in 2012 3. SSRIs should not be stopped abruptly due to potential withdrawal symptoms, and any discontinuation should be gradual under medical supervision, as highlighted in a study from 1999 4.