Here's a throwback Thursday episode originally cast in March of 2021, where we're going to look

at the question of whether adding a Z-hypnotic improves antidepressant response.

And stay tuned to the very end, where I'm going to update it with new research.

We all know that when you sleep better, you feel better. So it shouldn't come as a surprise that a sleep

medicine like a Zopaclone helps depression and anxiety. But do they all help, or is it just a Zopaclone?

And is it possible that this hypnotic has direct antidepressant and anxiolytic effects?

Welcome to the Carlislech Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlisat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Some men, no doubt, will before sleep consider one thought, I am alone. But some, in the mercy of God or booze, do not. Long stare at the dark ceiling.

That's the last stanza of a poem by Robert Penn Warren,

and it tells us something about what it's like to be depressed and unable to sleep.

When the lights are down, the ceiling is dark.

There is nothing to distract from the ruminative thoughts that make depression so painful.

Last month, we covered the long and complicated relationship of benzodiazepines and depression that culminated in over a dozen controlled trials, where the benzos, in particular

Al-Prasalam, Xanax, did a pretty good job of relieving depression, even when compared head-to-head

against a tricyclic antidepressant.

Today we're going to talk about the successor to the benzos, the Z-hypnotics, and whether

they can augment antidepressants in depression and anxiety disorders.

They are called the Z hypnotics, because all of them start with the letter Z.

First came Zoperclone, I'm Evane, which is not available in the US, but has been used in Europe since 1986.

Then Zolpidim, Ambien, released in 1992.

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