SSRIs & Sleeping pills
Selective serotonin reuptake inhibitors (SSRIs) are a class of medications commonly used to treat depression, anxiety disorders, and other mental health conditions. Some of the most popular and commonly prescribed SSRIs include:
Fluoxetine (Prozac) - This is one of the oldest and most widely used SSRIs. It is used to treat depression, obsessive-compulsive disorder (OCD), and bulimia nervosa.
Sertraline (Zoloft), Paroxetine (Paxil) - these medications are used to treat depression, OCD, panic disorder, and social anxiety disorder.
Escitalopram (Lexapro), Citalopram (Celexa) - these medications are used to treat depression and generalized anxiety disorder.
SSRIs work by increasing the levels of the neurotransmitter serotonin in the brain. Serotonin is a chemical messenger that plays a key role in regulating mood, emotions, and behavior. By blocking the reuptake of serotonin, SSRIs increase the availability of serotonin in the brain, which can help alleviate symptoms of depression and anxiety.
Sleeping pills, on the other hand, work by slowing down the activity in the brain to promote sleep. The combination of SSRIs and sleeping pills in most cases can increase the risk of certain side effects and dangers. The sedative effects of sleeping pills may be enhanced. This can increase the risk of side effects such as drowsiness, dizziness, and difficulty concentrating. Additionally, the combination may increase the risk of falls and accidents.
There are several different classes of medications that are commonly used as sleeping pills. We will briefly go through the main groups and identify possible side effects:
Benzodiazepines: Temazepam (Restoril), Estazolam (Prosom), Triazolam (Halcion), Diazepam (Valium). Since SSRIs can inhibit the work of certain cytochromes of the P450 system, thereby they can increase the concentrations of benzos and slow their withdrawal from the body, which may cause negative side effects. However, a combination of these substances can be used in the treatment of depressive disorders with severe anxiety. But this requires careful selection of a specific drug, dosages, and monitoring of the human condition.
Non-Benzodiazepine Hypnotics: Zolpidem (Ambien), Eszopiclone (Lunesta),
Zaleplon (Sonata). The situation here is the same as with benzos. If SSRI inhibits the work of cytochrome CYP3A4, it will slow down the processing and elimination of sleeping pills, which can lead to side effects.
Melatonin Receptor Agonists: Ramelteon (Rozerem), Tasimelteon (Hetlioz). In this case, everything is even more distributed. Thus, the simultaneous use of Ramelteon and Prozac does not cause clinically significant effects or an increase in the number of adverse events. At the same time, the combination of Ramelteone with Fluvoxamine (a strong CYP1A2 inhibitor) increased the concentration of sleeping pills in the blood by about 190 times.
Some Antidepressants can also be effective at promoting sleep. Representative examples include Trazodone (Desyrel), Doxepin (Silenor). In general, combining two antidepressants from different groups without consulting a doctor is a bad idea. Don't do that.
Orexin Receptor Antagonists: Suvorexant (Belsomra). Cytochrome CYP3A4 inhibitors can enhance the effect of suvorexant, however, even strong inhibitors cause a significant increase in the concentration of the drug. In the case of medium and weak inhibitors, such an interaction may not have clinical significance.
Barbiturates: Phenobarbital, Pentobarbital. There is poorly confirmed information that this combination increases the activity and toxicity of all drugs included in the combination.
Antihistamines: Diphenhydramine (Benadryl), Doxylamine (Unisom). There may be an increase in the depressing effect of sleeping pills on the central nervous system.
Due to the multitude of possible substance combinations and their varied effects, providing a definitive and unbiased answer can prove to be a challenging task. Primarily, we urge individuals to identify the reason behind the substance combination. In certain cases, such combinations are used sparingly to treat specific conditions. Otherwise, the practice is deemed to be futile and potentially hazardous.
Considering the above, we strongly recommend a meaningful approach to this combination.
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