Sedation antidepressants causing

May cause insomnia, administer in am sedating antidepressants, in small doses (i.e., trazadone 50 mg), frequently administered hs, concurrently... 

Q9 Tricyclic antidepressants cause sedation and possess several other side effects. The antimuscarinic (atropine-like) effects of these agents include dry mouth, blurred vision, raised intraocular pressure, postural hypotension, impotence, changes in cardiac rhythm and muscle tremors. They can also cause obstruction of the bladder neck, followed by difficulty in initiating micturition. 

Sleeplessness in ALS has numerous causes. Respiratory insufficiency, difficulty repositioning in bed, anxiety and depression can all contribute to poor sleep. Treatment of depression with sedating antidepressants such as mirtazapine, tricyclic antidepressants, or trazadone can help promote sleep. Zolpidem, a non benzodiazepine sleep aid, is effective and carries a low risk of respiratory depression. Other medications that can be helpful include anithistamines, chloral hydrate and selective use of benzodiazepines (Gordon and Mitsumoto, 2006). Non-invasive positive pressure ventilation can help relieve orthopnea in those with respiratory muscle weakness, and special equipment, such as a hospital bed, can reduce nighttime discomfort. 

FIGURE 20 Amitriptyline, a tricyclic antidepressant, causes sedation and orthostatic hypotension. In addition, it possesses strong anticholinergic properties. 

FIGURE 41 Desipramine, a tricyclic antidepressant, causes a strong blockade of the serotonin uptake mechanism. It causes a mild degree of sedation and orthostatic hypotension and has a weak anticholinergic property. 

Antidepressant medications are designed to counteract these symptoms. However, when alcohol, itself a depressant, is combined with antidepressant medications, serious consequences can result. For example, some antidepressants cause sedation and drowsiness. Alcohol has similar effects, and the combination of the two could easily cause a person to fall asleep while driving. Initially, alcohol might seem to improve the mood of a depressed person, but its overall effect is often to ino-ease the depression symptoms. 

Trazodone routinely causes sedation, which is why it is used far more often as an adjunct with other antidepressants for sleep than as a primary agent for the treatment of depression. Priapism is a rare but serious adverse effect in males who take trazodone. In addition, orthostatic hypotension and dizziness are more common with trazodone than with nefazodone because the latter agent has a weaker effect at a-adrenergic receptors and also has a balancing of adrenergic effects owing... 

Common side effects of the SSRIs are somnolence, nausea, ejaculation disorders, decreased libido, dry mouth, insomnia, and fatigue. Tricyclic antidepressants (TCAs) commonly cause sedation, orthostatic hypotension, anticholinergic effects, and weight gain. TCAs are very toxic on overdose. 

Geriatric Considerations - Summary Cyclobenzaprine is a skeletal muscle relaxant which is structurally related to the tricyclic antidepressants with anticholinergicprop-erties and it is very sedating. It is used for acute muscle pain and should not be used chronically. Its usefulness in the older adult is limited by its potential to cause adverse effects. 

A potent antidepressant drug, it does not cause sedation. In CNS it inhibits the neuronal uptake of 5-HT. It shows negligible binding to histaminergic, muscarinic, oq adrenergic receptors, so it is devoid of anticholinergic and hypotensive side effects. 

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