5 tables to master: the clinical application of 48 kinds of drugs for insomnia, anxiety and depression

Depression is a mental illness with high prevalence, high recurrence rate, and high burden rate
.

According to statistics from the World Health Organization, depression has become the world's fourth most common disease

Depression is a mental illness with high prevalence, high recurrence rate, and high burden rate

Therefore, depression, anxiety and insomnia comprehensive treatment become the treatment of these diseases on the international new trend of new trends

 Commonly used antidepressants include selective 5-HT reuptake inhibitors (SSRIs), 5-HT and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and specific 5-HT antidepressants ( NaSSAs), tricyclic and heterocyclic drugs (TCAs), monoamine oxidase inhibitors (MAOIs), reversible monoamine oxidase A inhibitors (RIMAs)
.

In addition, there are anti-anxiety and anti-depressant compound preparations, such as flupentixol and melitrazin

 Commonly used antidepressants Antidepressants include selective 5-HT reuptake inhibitors (SSRIs), 5-HT and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and specific 5-HT antidepressants Depressants (NaSSAs), tricyclic and heterocyclic drugs (TCAs), monoamine oxidase inhibitors (MAOIs), reversible monoamine oxidase A inhibitors (RIMAs)

Medications for insomnia Medications for insomnia

Drugs that can be used for difficulty falling asleep 

Drugs that can be used for difficulty falling asleep 

 

Drugs used to treat sleep maintenance difficulties

Drugs used to treat sleep maintenance difficulties

Sleep medication for people with depression and anxiety

Sleep medication for people with depression and anxiety

 

Sleep medication for special populations

Sleep medication for special populations

Drug treatment of insomnia with depression

Drug treatment of insomnia with depression Drug treatment of insomnia with depression

For insomnia with depression, SSRIs/SNRIs/low-dose mirtazapine combined with SSRIs or SNRIs are the first choice, supplemented with sedative and hypnotics when necessary
.

The first choice for sedative and hypnotics is non-BZDs, such as zolpidem, zopiclone, dexzopiclone, zaleplon, or sedative antidepressants such as trazodone, mirtazapine, and can be supplemented with sedation and antidepressants Effective mixture drugs or Chinese patent medicines; after the improvement of insomnia, non-BZDs/BZDs and other sedative hypnotics should be gradually reduced until the drug is stopped, and SSRIs/SNRIs/mirtazapine should be used for maintenance treatment

For insomnia with depression, SSRIs/SNRIs/low-dose mirtazapine combined with SSRIs or SNRIs are the first choice, supplemented by sedative and hypnotics when necessary

Drug treatment of insomnia with anxiety Drug treatment of insomnia with anxiety

(1) BZDs : Alprazolam, clonazepam, lorazepam, diazepam, etc.
in this class of drugs have a better effect on patients with insomnia and anxiety.
They can reduce the frequency of night awakening, but can significantly reduce slowness.
Wave sleep, leading to a decline in recovery after sleep
.

The most common adverse reactions include dizziness, dry mouth, loss of appetite, constipation, delirium, forgetting, falls, potential dependence, residual sedation the next day, etc.

(1) BZDs (1) BZDs : Alprazolam, clonazepam, lorazepam, diazepam, etc.

(2) Anti-anxiety/depressants with sedative effect (2) Anti-anxiety/depressants with sedative effect : especially suitable for the treatment of anxiety and insomnia.

Summary summary

In the drug treatment of insomnia with depression and anxiety, the priority of depression and anxiety should be distinguished before treatment.
The choice of drugs depends on the severity of symptoms and the pattern of symptoms, and the selection of drugs should pay attention to the principle of individualization
.

A balance must be maintained between efficacy and tolerability, as well as medication safety and patient preference

In the drug treatment of insomnia with depression and anxiety, the priority of depression and anxiety should be distinguished before treatment.
The choice of drugs depends on the severity of symptoms and the pattern of symptoms.
The selection of drugs should pay attention to the principle of individualization
.
A balance must be maintained between efficacy and tolerability, as well as medication safety and patient preference.
Medication safety and patient preference must also be considered
.

American psychologist Baker designed a depression self-rating scale , which contains 21 groups, each group has 4 sentences, and each sentence has a certain value as a grade
.
You can choose the sentence that best suits your situation based on your feelings over the past week
.
After completing all 21 groups, based on the total score, you can understand clearly whether you have depression and the degree of depression
.
Welcome to scan the QR code below for self-test~

American psychologist Baker designed a depression self-rating scale , which contains 21 groups, each group has 4 sentences, and each sentence has a certain value as a grade
.
You can choose the sentence that best suits your situation based on your feelings over the past week
.
After completing all 21 groups, based on the total score, you can understand clearly whether you have depression and the degree of depression
.
Welcome to scan the QR code below for self-test~ Welcome to scan the QR code below for self-test~

references:

[1].
Chinese Medical Association Neurology Branch, Chinese Adult Insomnia Diagnosis and Treatment Guidelines (2017 Edition), Chinese Journal of Neurology, 2018 52 (5): 324-335

diagnosis

[2].
Cipriani A, Furukawa TA, Salanti G, et al.
Comparative efficacy and acceptability of 21 antidepressant drugs for the acutetreatment of adults with major depressive disorder: a systematic review andnetwork meta-analysis.
Lancet 2018;391:1357-66.
3 .

[3].
Bayes A, Parker G.
How to choose anantidepressant medication.
Acta Psychiatr Scand.
2019;139(3):280-291.
5.

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