Should I Take My Antidepressant at Night or in the Morning?
Updated August 27, 2014.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
While it does not matter with some antidepressants whether you take them at night or in the morning, there are distinct advantages to taking them at a particular time of day with others.
The benefits that can be obtained from the correct timing of a individual's antidepressant dosage fall into two categories: maximizing the effectiveness of the medication and minimizing -- and perhaps even using to the person's advantage -- any side effects that he or she might be experiencing.
Taking Antidepressants Based Upon Efficacy
One example of an antidepressant which has been shown to have better efficacy if taken at a particular time of day is clomipramine. In a double-blind study involving 30 depressed patients who were given a daily dose of 150 mg of this drug for four weeks, it was found that a noon dose of the medication was more efficacious than a morning or bedtime dose.
However, other antidepressants, such as citalopram, sertraline and venlafaxine in its sustained-release formulation, do not appear to be any more or less effective when taken at varying times of the day.
Not all antidepressants have had this type of study performed, however. Your doctor, pharmacist or the manufacturer's information sheet will be able to provide you with specific recommendations about whether your antidepressant should be taken at a particular time of day for the best results.
Taking Antidepressants Based Upon Side Effects
Eli Lilly & Co., the maker of the Prozac brand of fluoxetine recommends that this antidepressant be taken in the morning because it can make some patients feel more energized, especially at the beginning of treatment.
On the other hand, when fluoxetine is given in combination with olanzapine as a therapy for treatment-resistant depression, it is recommended to be taken in the evening. Eli Lilly markets this drug combination under the brand name SYMBYAX.
Paroxetine is also generally given in the morning in order to prevent sleeplessness at night, however, it may be given at bedtime if it causes drowsiness when taken in the morning.
Wellbutrin is another antidepressant which should be taken in the morning in order to prevent insomnia at night.
Certain other medications, on the other hand, generally tend to make patients feel drowsy so they are better tolerated if taken at bedtime. Among these medications are fluvoxamine, mirtazepine and tricyclic antidepressants such as amitriptyline, clomipramine, desipramine, doxepine, imipramine and nortriptyline.
In patients who are suffering from insomnia, this side effect may actually work to a person's advantage, helping them to fall asleep. However, in people who are having trouble with energy it may be beneficial to the them to take an antidepressant in the morning which is more activating as opposed to one which is more sedating.
A Word of Caution
If you are currently taking one of the medication listed in this article, you should not attempt to make a change in your treatment plan without consulting with your doctor first. This article is provided for informational purposes only and is not intended to replace a consultation with your personal physician. These are general recommendations which may or many not be applicable to your own unique situation.
Sources:
McKenzie, Megan. "Optimal Timing of Medications." Ochsner Pharmacy. Ochsner Pharmacy. Accessed: January 26, 2014.
Stahl, S.M. "Fluoxetine." Stahl's Essential PsychopharmacologyOnline. Cambridge University Press. 2008. Accessed: January 26, 2014.
"Understanding Antidepressant Medications." U.S. Food and Drug Administration. U.S. Department of Health and Human Services. January 9, 2009. Accessed: January 26, 2014.
Zhu, L.L. et. al. "Optimal Time to Take Once-Daily Medications in Clinical Practice: Antidepressants." International Journal of Clinical Practice. 62.10 (2008) : 1560-1571.