benzodiazepines and 'Z' drugs), a different antidepressant, waiting list control or treatment as usual. Any antidepressant as monotherapy at any dose whether compared with placebo, other medications for insomnia (e.g. Randomised controlled trials (RCTs) of adults (aged 18 years or older) with a primary diagnosis of insomnia and all participant types including people with comorbidities. We updated the searches to December 2017, but these results have not yet been incorporated into the review. This review incorporated the results of searches to July 2015 conducted on electronic bibliographic databases: the Cochrane Central Register of Controlled Trials (CENTRAL, 2015, Issue 6), MEDLINE (1950 to 2015), Embase (1980 to 2015) and PsycINFO (1806 to 2015). To assess the effectiveness, safety and tolerability of antidepressants for insomnia in adults. This use of unlicensed medications may be driven by concern over longer‐term use of hypnotics and the limited availability of psychological treatments. Antidepressant use for insomnia is widespread, but none is licensed for insomnia and the evidence for their efficacy is unclear. benzodiazepines and 'Z' drugs) are licensed for sleep promotion, but can induce tolerance and dependence, although many people remain on long‐term treatment. ![]() Insomnia disorder impairs quality of life and is associated with an increased risk of physical and mental health problems including anxiety, depression, drug and alcohol abuse, and increased health service use. sleep onset, maintenance, early waking, impairment of daytime functioning). All rights reserved.Insomnia disorder is a subjective condition of unsatisfactory sleep (e.g. Trazodone however, presented good tolerance in the short-term treatment of insomnia.Įfficacy Insomnia Meta-analysis Tolerability Trazodone.Ĭopyright © 2018 Elsevier B.V. Trazodone was effective in sleep maintenance by decreasing the number of early awakenings and it could significantly improve perceived sleep quality, although there were no significant improvements in sleep efficiency or other objective measures. Moreover, no significant difference was found in the outcome of tolerability or acceptability. As to secondary efficacy outcomes, we only found a significant reduction for trazodone in NAs (SMD = -0.51, 95%CI -0.97 to -0.05) compared to the placebo, with non-significant differences found in SL, TST, or WASO between trazodone and placebo. However, patients receiving trazodone perceived better SQ than those receiving the placebo (SMD = -0.41, 95% CI -0.82 to -0.00, P = 0.05) with a non-significantly moderate heterogeneity (I 2 = 65%, P = 0.06). There was no significant improvement for trazodone in SE% (SMD = 0.09, 95% confidence interval (CI) -0.19 to 0.38, P = 0.53) with a non-significant heterogeneity (I 2 = 0%, P = 0.59). Seven trials involving 429 patients were included. ![]() Tolerability outcome was measured by the number of patients who discontinued for adverse events and acceptability outcome was measured by the number of patients who discontinued for all causes. Secondary efficacy outcomes included sleep latency (SL), total sleep time (TST), the number of awakenings (NAs), waking time after sleep onset (WASO). Primary efficacy outcomes included sleep efficiency (SE%) and self-reported sleep quality (SQ). Standardized mean differences (SMD) and the odds ratios (OR) were estimated using a random-effect model. ![]() Only randomized placebo-controlled trials were included. To assess the efficacy and tolerability of trazodone compared with placebo in patients with insomnia.Įlectronic databases were searched and relevant reports were hand-screened to identify eligible trials.
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