Antidepressants, not sleep drugs, often prescribed for insomnia * Story Highlights * Doctors prescribed more antidepressants for insomnia

Insomnia, the inability to fall or stay asleep, can make the days feel fuzzy and the nights never-ending.

The disorder can increase the risk for depression and suicidal thoughts, lower work productivity and even raise blood pressure, studies have shown.

About 40 million Americans have chronic sleep disorders that prevent them from getting good rest. Singer Michael Jackson struggled with insomnia, a nutritionist who worked for him told CNN. Sources close to Jackson told CNN that during a world tour in the mid-'90s, the pop star traveled with an anesthesiologist who would "take him down" at night, then "bring him back up."

Stress or traumatic events can trigger the sleeping disorder. Insomnia drugs help the patient sleep, but they do not treat the underlying cause, which could be a result of another illness, life changes or shifting work schedules. And patients who seek relief for insomnia may not receive the most effective prescription.

Over the last two decades, doctors treating sleep disorders have prescribed more antidepressants than insomnia drugs, according to several published analyses. And there is insufficient evidence that most antidepressants are effective in treating insomnia, concluded a National Institutes of Health panel that convened on the topic in 2005.

Doctors may be factoring in cost considerations and their own familiarity with prescribing antidepressants relative to newer sleep medications, experts said.

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Medication insufficient for depression due to traumatic head injury

In a large clinical sample of patients with traumatic brain injury with symptoms of major depression, antidepressant medication has been shown to lead to remission of symptoms in a minority of patients.

"Although citalopram treatment was associated with a statistically significant reduction in depressive symptoms, the results of this study show the response rate in the present sample is substantially lower than previously reported in past research," says Dr. Mark Rapoport, lead investigator of the study and geriatric psychiatrist at Sunnybrook Health Sciences Centre. "Our findings suggest that other multidisciplinary treatment modalities will be needed to achieve adequate control of depressive symptoms following traumatic brain injury (TBI)."

The goal of the study was to examine the rates of response and remission in patients treated with a selective serotonin reuptake inhibitor (SSRI), citalopram in this case, for major depression following TBI.
In the past, open-label studies of SSRIs have shown statistically significant reductions on depression, but methodological problems in the studies and the small samples limited the ability to interpret the results.
Therefore the goal of this study was to assess the response of patients in a larger sample of clinical patients with mild-to-moderate TBI.

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