Pharmacological Treatment for Insomnia in Patients with Major Depressive Disorder
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Authors
Brietzke, Elisa
Vazquez, Gustavo
Kang, Melody J. Y.
Soares, Claudio
Date
2019-05-16
Type
journal article
Language
Keyword
Hypnotic , Insomnia , Major depressive disorder , Mood disorders , Sleep
Alternative Title
Abstract
Introduction: Insomnia in Major Depressive Disorder (MDD) is highly prevalent and associated with increased suffering and functional impairment. Effective, evidence-based treatments for insomnia in MDD are an unmet need in clinical practice.Areas covered: Herein, the authors provide a review of the clinical correlates, putative neurobiological mechanisms and treatment options for the management of insomnia in individuals with MDD.Expert opinion: Sleep disturbances in MDD should be recognized as at least one of the following: (1) a domain of depressive psychopathology; (2) a consequence of rhythm disruptions; (3) a manifestation of comorbidities of sleep disturbances; (4) a manifestation of the influence of sex hormones in the brain in MDD; (5) a general medical comorbidity; and (6) a side effect of antidepressant medications. Assessment of insomnia in clinical practices is routinely performed with the use of non-structured interviews. Other methods such as standardized questionnaires and sleep diaries, along with complementary methods such as actigraphy and polysomnography are more scarcely applied. Smartphones and personal devices offer a promising strategy with the use of passive, long lasting, and ecologically valid assessments despite the lack of studies specifically targeting insomnia in individuals with MDD. New therapeutic approaches are essential, including novel targets such as orexins/hypocretins and the endocannabinoid system.
Description
This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Opinion on Pharmacotherapy on 2019 available online: http://dx.doi.org/10.1080/14656566.2019.1614562
Citation
Brietzke, E., Vazquez, G. H., Kang, M. J. Y., & Soares, C. N. (2019). Pharmacological treatment for insomnia in patients with major depressive disorder. Expert Opinion on Pharmacotherapy, 1–9. doi:10.1080/14656566.2019.1614562
Publisher
Taylor and Francis