SynthesisSleep2023
Adverse effects of 21 antidepressants on sleep during acute-phase treatment in major depressive disorder: a systemic review and dose-effect network meta-analysis.
Synthesis in Sleep, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Effects of antidepressant administration on physical performance and perceived exertion in athletes: systematic review and meta-analysis.International journal of clinical pharmacy · 2026Pooled it
- The association between depressive symptoms and sleep quality in patients with multiple sclerosis: a systematic review and meta-analysis.BMC neurology · 2026Pooled it
- Current practices in modelling dose-response relationships in network meta-analyses of depression treatments: a meta-research study.BMJ open · 2026Article
- Article
- Comparative Sleep Architecture Profiles of Antidepressants in Mice: Pharmacological Characterization of Paroxetine, Sertraline, Duloxetine, Mirtazapine and Vortioxetine.Pharmacology research & perspectives · 2026Article
- Independent associations and isotemporal substitution analysis of 24-hour movement behaviors and depression among Chinese older adults.BMC psychology · 2026Article
- Residual daytime sleepiness in patients with obstructive sleep apnoea syndrome: A service review in a tertiary sleep centre.Sleep & breathing = Schlaf & Atmung · 2026Article
- Review
- Successful management of trichotillomania in a patient with SSRI-induced hypersomnia: a case report.Frontiers in psychiatry · 2026Article
- Trazodone effectiveness in depression (TED): a comparative evaluation of effect sizes trazodone extended release and SSRIs in the treatment of major depressive disorder.Frontiers in pharmacology · 2026Article
- Tai chi in mental health interventions: a narrative review comparing its role with pharmacotherapy and psychotherapy.Frontiers in psychology · 2026Review
- Pharmacological modulation of hyperarousal in insomnia associated with major depressive disorder: a narrative review of sedating antidepressants and orexin receptor antagonists.Frontiers in psychiatry · 2026Review
- Neuroinflammation and Natural Antidepressants: Balancing Fire with Flora.Biomedicines · 2025Review
- Pharmacological Monotherapy for Depressive Disorders: Current and Future-A Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
- Acceptance and commitment therapy for psychiatric inpatients diagnosed with depression and insomnia: a multiple-baseline single-case study.Frontiers in psychiatry · 2025Article
- Real-world analysis of gender differences in drug-induced insomnia: evidence from FAERS and CVARDD databases.Frontiers in neurology · 2025Article
- Polysomnographic insights into the attention-deficit/hyperactivity disorder and obstructive sleep apnea connection in children.Frontiers in sleep · 2024Article
- Association between polypharmacy and the long-term prescription of hypnotics in Japan: a retrospective cross-sectional study.Frontiers in psychiatry · 2024Article
- Effectiveness of Vortioxetine for the Treatment of Emotional Blunting in Patients with Major Depressive Disorder Experiencing Inadequate Response to SSRI/SNRI Monotherapy in Spain: Results from the COMPLETE Study.Neuropsychiatric disease and treatment · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
STUDY
objectivesSleep-related adverse effects during acute treatment with antidepressants undermine adherence and impede remission. We aimed to address subtypes of sleep-related adverse effects and depict the relationship between dose and sleep-related adverse events.
methodsWe searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science for double-blind randomized controlled trials of depression published before April 30th, 2023. Eligible studies reporting sleep-related adverse effects during short-term monotherapy were included. The odds ratios (ORs) for sleep-related adverse effects were addressed with network meta-analysis. A Bayesian approach was used to depict the dose-effect relationship. Heterogeneity among studies was assessed using the τ2 and I2 statistics. Sensitivity analyses were performed without studies featuring high risk of bias.
resultsStudies with 64 696 patients were examined from 216 trials. Compared to placebo, 13 antidepressants showed higher ORs for somnolence, of which fluvoxamine (OR = 6.32; 95% CI: 3.56 to 11.21) ranked the top. Eleven had higher risks for insomnia, reboxetine ranked the top (OR = 3.47; 95% CI: 2.77 to 4.36). The dose-effect relationships curves between somnolence or insomnia and dose included linear shape, inverted U-shape, and other shapes. There was no significant heterogeneity among individual studies. The quality of evidence for results in network meta-analyses was rated as very low to moderate by Grading of Recommendations Assessment, Development, and Evaluation.
conclusionsMost antidepressants had higher risks for insomnia or somnolence than placebo. The diverse relationship curves between somnolence or insomnia and dose of antidepressants can guide clinicians to adjust the doses. These findings suggest clinicians pay more attention to sleep-related adverse effects during acute treatment with antidepressants.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.