Although they are not licensed for this use, sedatives like Ambien (zolpidem), Ativan (lorazepam), Klonopin (clonazepam), Valium (diazepam), and Xanax (alprazolam) are often prescribed to depressed individuals who complain of anxiety, agitation, or insomnia.
There are many good reasons to refuse sedatives. For example, all sedatives are potentially addictive. They can increase sadness, irritability, anger, and impulsive behaviors such as suicide, aggression, binge drinking, and inappropriate drug use. Studies have shown that people who take sedatives may not even be aware that they are more irritable and angry. Sedatives also impair learning, sabotage memory, and interfere with mental processes. The situation may be worse if you take sedatives for a long time. After you finally stop taking sedatives, the mental deficits they cause may take over six months to go away.
Some patients have had psychotic episodes with the latest sleeping medicines. Sedatives can also cause failure of the breathing response and death if taken in overdose or with alcohol.
Insomnia is one of the diagnostic symptoms of unipolar major depression. If one of my patients is sleeping poorly, my first step is to strengthen their depression treatment and help them improve their sleeping habits. If an additional medication is necessary for sleeping, I suggest starting with low doses of Benadryl (diphenhydramine, an over-the-counter antihistamine allergy medicine). The antidepressant Desyrel (trazodone) makes people sleepy during the night, and I often use it as both an antidepressant and a treatment for insomnia.
You should know that it is very common now for medical doctors to prescribe sedatives like Valium or Xanax to the bereaved. This is a well-meaning gesture, but sedatives can interfere with the process of recovery from grief. It is quite annoying to wake up from a few months of medical fog to find that you still have your grief recovery period ahead of you. Worse, sedatives can make people more depressed and more likely to have accidents and perform impulsive behaviors like suicide.
