Which medications in the drug class Antidepressants, TCAs are used in the treatment of Insomnia?

Updated: Sep 11, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
  • Print

Antidepressants, TCAs

Except for low-dose doxepin (Silenor), drugs in this category are not approved for treatment of insomnia by the US Food and Drug Administration (FDA), and there have been few randomized, placebo-controlled trials demonstrating efficacy for insomnia. Nevertheless, these agents can be useful, especially in patients with comorbid depression or anxiety.


Amitriptyline is a tricyclic antidepressant (TCA) with sedative effects. It inhibits reuptake of serotonin and/or norepinephrine at the presynaptic neuronal membrane, which increases concentration in the central nervous system (CNS).

Doxepin (Silenor)

Low-dose doxepin is FDA approved for sleep-maintenance insomnia. It is available in 3- and 6-mg tablets.

Nortriptyline (Pamelor)

Nortriptyline has demonstrated effectiveness in the treatment of chronic pain.

By inhibiting the reuptake of serotonin and/or norepinephrine by the presynaptic neuronal membrane, this drug increases the synaptic concentration of these neurotransmitters in the CNS.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!