Table 2.
Effects of commonly used drugs on sleep and waking
Drug Type | Examples | Pharmacologic Effect | Neurobiologic Mechanism | Clinical Effects |
---|---|---|---|---|
Selective serotonin reuptake inhibitors (SSRIs) | Fluoxetine | Increase extracellular levels of 5-HT | 5-HT inhibits REM sleep-producing cells | Decreased REM sleep |
Fluvoxamine | ||||
Citalopram | ||||
Tricyclic antidepressants | Amitriptyline | Increase extracellular levels of 5-HT and NE | 5-HT and NE inhibit REM sleep-producing cells | Decreased REM sleep |
Nortriptyline | ||||
Clomipramine | ||||
Desipramine | ||||
Traditional, amphetamine-like stimulants | Amphetamine | Increase extracellular levels of DA and NE | Increased DA and NE signaling | Increased wakefulness |
Dextroamphetamine | ||||
Methylphenidate | ||||
Wake-promoting, non-traditional stimulants | Modafinil | Increase extracellular levels of DA | Increased DA signaling | Increased wakefulness |
Armodafinil | ||||
Benzodiazepines | Diazepam | Enhance GABA signaling via GABAA receptors | GABA inhibits the arousal systems | Increased sleep |
Clonazepam | ||||
Lorazepam | ||||
Triazolam | ||||
Non-benzodiazepine sedative hypnotics | Zolpidem | Enhance GABA signaling via GABAA receptors | GABA inhibits the arousal systems | Increased sleep |
Zaleplon | ||||
Zopiclone | ||||
Classic antihistamines | Diphenhydramine | Block HA H1 receptors | Reduced HA signaling | Increased sleep |
Triprolidine | ||||
Typical antipsychotics | Haloperidol | Block DA receptors | Reduced DA signaling | Increased sleep |
Chlorpromazine |