Posted by Elizabeth on October 12, 1999, at 1:54:29
In reply to Re: TCA's and sleep, posted by saint james on October 10, 1999, at 19:58:38
I think what you want is enhanced slow-wave sleep, not REM sleep. (REM enhancers, such as the cholinesterase inhibitors used for Alzheimer's disease, tend to cause insomnia and broken sleep, though not always.) However, if you are concerned about your sleep architecture and not simply about getting more sleep, you probably want to see a sleep specialist.
Pretty much all TCAs suppress REM sleep and enhance SWS because they are anticholinergic and increase norepinephrine. They're often used for narcolepsy (protriptyline and amitriptyline in particular) for this reason.
The most sedating TCAs, which increase sleep continuity quite a lot, are amitriptyline (Elavil) and doxepin (Sinequan). Doxepin has fewer peripheral side effects.
If these are too sedating, imipramine (Tofranil) and clomipramine (Anafranil) are probably next, followed by nortriptyline (Pamelor). Nortriptyline has fewer side effects and may be the best choice if it is sedating enough. It's a good compromise if you want sedation but can do with minimal dry mouth, constipation, etc.
Protriptyline especially, and also desipramine, may be very activating and aren't likely to be good sleep aids.
poster:Elizabeth
thread:12957
URL: http://www.dr-bob.org/babble/19991001/msgs/13013.html