Psychobiology Department, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Braz J Psychiatry. 2011 Mar;33(1):91-5. doi: 10.1590/s1516-44462011000100017.
The present review addresses the relationship between sleep and depression and how serotonergic transmission is implicated in both conditions.
Literature searches were performed in the PubMed and MedLine databases up to March 2010. The terms searched were "insomnia", "depression", "sedative antidepressants" and "serotonin". In order to pinpoint the sedative antidepressants most used to treat insomnia, 34 ISI articles, mainly reviews and placebo-controlled clinical trials, were selected from 317 articles found in our primary search.
Sleep problems may appear months before the diagnosis of clinical depression and persist after the resolution of depression. Treatment of insomnia symptoms may improve this comorbid disease. Some antidepressant drugs can also result in insomnia or daytime sleepiness. Serotonin (5-HT) demonstrates a complex pattern with respect to sleep and wakefulness that is related to the array of 5-HT receptor subtypes involved in different physiological functions. It is now believed that 5HT2 receptor stimulation is subjacent to insomnia and changes in sleep organization related to the use of some antidepressants.
Some drugs commonly prescribed for the treatment of depression may worsen insomnia and impair full recovery from depression. 5-HT2 receptor antagonists are promising drugs for treatment strategies since they can improve comorbid insomnia and depression.
本综述探讨了睡眠与抑郁之间的关系，以及 5-羟色胺能传递在这两种情况下是如何起作用的。
对截至 2010 年 3 月的 PubMed 和 MedLine 数据库进行了文献检索。检索词包括“失眠”、“抑郁”、“镇静抗抑郁药”和“5-羟色胺”。为了确定最常用于治疗失眠的镇静抗抑郁药，从我们的初步搜索中找到了 317 篇文章，选择了其中 34 篇 ISI 文章，主要是综述和安慰剂对照临床试验。
睡眠问题可能在临床抑郁症诊断前数月出现，并在抑郁症缓解后持续存在。治疗失眠症状可能会改善这种共病。一些抗抑郁药也会导致失眠或白天嗜睡。5-羟色胺（5-HT）在睡眠和觉醒方面表现出复杂的模式，这与涉及不同生理功能的 5-HT 受体亚型的广泛分布有关。现在认为，5-HT2 受体的刺激与失眠有关，与一些抗抑郁药的使用相关的睡眠结构变化。
一些常用于治疗抑郁症的药物可能会加重失眠，并影响抑郁症的完全康复。5-HT2 受体拮抗剂是一种有前途的治疗策略药物，因为它们可以改善共病性失眠和抑郁。
