Could Your Medication Be Causing Insomnia?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Impaired sleep (insomnia) is a major complaint from patients in my practice, with huge personal and economic costs. When it comes to treatments for either difficulty going to sleep or staying asleep, looking for an easily reversible cause is the first step.

One of the first places to look: many drugs may affect the quality and duration of sleep. These 18 meds have been shown in studies to do just that. If you are struggling with insomnia and take one of these medications, asking your doctor to try an alternative may allow you to get some zzz’s.

  1. Prednisone. A steroid given for asthma or COPD, hives, and other skin conditions, prednisone has been shown to disrupt your sleep.
  2. Sertraline (Zoloft). Studies show sertraline is a significant disruptor of sleep. Sertraline is a selective serotonin reuptake inhibitor (SSRI) prescribed for depression and obsessive compulsive disorder—if you are struggling with sleep disturbance after starting sertraline, ask your doctor about another option in the same class of meds.
  3. Paroxetine (Paxil). An SSRI used for anxiety, depression, and OCD, studies reveal that paroxetine significantly affects sleep.
  4. Fluoxetine (Prozac). Another well known SSRI used for depression, panic disorder, OCD, and premenstrual dysphoric disorder, fluoxetine has also been shown in studies to contribute to insomnia.
  5. Citalopram (Celexa). Another SSRI that may disrupt sleep.
  6. Fluvoxamine (Luvox). Yet another old school SSRI, this antidepressant may disrupt your sleep.
  7. Donepezil (Aricept). Donepezil is indicated for the treatment of dementia, specifically Alzheimer’s, and may cause disrupted sleep in folks taking it.
  8. Venlafaxine (Effexor). Slightly different from SSRIs, this SNRI (serotonin, norepinephrine reuptake inhibitor) is prescribed for generalized anxiety disorder and depression. Studies show it significantly contributes to insomnia.
  9. Pramipexole (Mirapex and Mirapex ER). These medications are used for restless leg syndrome (RLS) and Parkinson’s disease. Studies show they may contribute to sleep disturbance.
  10. Rotigotine (Neupro). Neupro is a brand-name-only patch prescribed for restless leg syndrome and Parkinson’s disease, and it may cause insomnia.
  11. Ropinirole (Requip). Another medication used for the treatment of restless leg syndrome, ropinirole may contribute to insomnia.
  12. Varenicline (Chantix). Prescribed for folks who want to quit smoking, studies reveal that Chantix may disrupt your sleep.
  13. Rivastigmine (Exelon). This patch is used for the treatment of dementia and has been shown in studies to affect sleep.
  14. Naltrexone (Revia). Naltrexone is an opioid receptor antagonist used for alcohol dependence. It’s also part of the new weight loss medication Contrave (a combination of naltrexone and bupropion). Naltrexone can negatively affect sleep.
  15. Olanzapine (Zyprexa). Olanzapine is used for bipolar disorder and psychosis associated with dementia and studies show it may contribute to insomnia.
  16. Levodopa. Part of Sinemet (a combination of levodopa and carbidopa), it’s used for restless leg syndrome as well as Parkinson’s disease and may cause insomnia.
  17. Amantadine (Symmetrel). Amantadine is an antiviral medication that also happens to be used for Parkinson’s disease and schizophrenia, and it may negatively impact sleep.
  18. Cabergoline (Dostinex). Cabergoline is a medication that’s effective both for restless leg syndrome and for lowering levels of prolactin in those with prolactin-producing pituitary tumors. Studies show cabergoline may cause insomnia.

Hope this helps.

Dr O.

Ref: Doufas A, Panagioutou O. Insomnia From Drug Treatments: Evidence From Meta-analyses of Randomized Trials and Concordance With Prescribing Information. Mayo Clin. Proc Jan 2017: 92(1): 72-87.

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