The effects of trazodone on sleep in patients treated with stimulant antidepressants.
OBJECTIVE
To evaluate the effects of trazodone on subjective and objective measures of sleep in depressed insomnia patients treated with selective serotonin reuptake inhibitors (SSRIs). SSRIs can exacerbate or cause new insomnia while alleviating other symptoms of depression. Trazodone has been reported to be an effective hypnotic for patients with antidepressant-associated insomnia.


METHODS
Twelve female patients were given either 100 mg trazodone or placebo for 7 days in a double-blind crossover design with a 7-day washout period. Polysomnographic recordings were repeated on the 3rd, 9th and 17th, 23rd nights after treatment with trazodone or placebo. Sleep was assessed by Pittsburgh sleep quality index (PSQI) at the beginning and end of the study. Psychological evaluation was done by Hamilton depression rating scale (HDRS).


RESULTS
Trazodone significantly increased total sleep time, percentage of stages 3+4, sleep efficiency index, sleep continuity index and decreased percentage of stage 1, number of awakenings, stage shifts compared to the baseline. This improvement was also obtained after 7 days of treatment. The PSQI score was reduced to 5+/-1.6 at the end of the study. HDRS was reduced to 11.5+/-4.5 with trazodone and to 12.2+/-3 with placebo.


CONCLUSIONS
Trazodone is effective in the treatment of antidepressant-associated insomnia.
Kaynak
Hakan
H
Department of Neurology, Sleep Disorders Unit, Cerrahpasa Medical School, University of Istanbul, Cerrahpasa, 34303 Istanbul, Turkey. kaynak@attglobal.net
Kaynak
Derya
D
Gözükirmizi
Erbil
E
Guilleminault
Christian
C
D000328:Adult; D018592:Cross-Over Studies; D003865:Major Depressive Disorder / Q000188:drug therapy; D004311:Double-Blind Method; D004576:Electromyography; D004585:Electrooculography; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D017286:Polysomnography; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D012895:Sleep, REM / Q000187:drug effects; D014196:Trazodone / Q000494:pharmacology / Q000627:therapeutic use*; D014851:Wakefulness / Q000187:drug effects
D006993:Hypnotics and Sedatives; D017367:Selective Serotonin Reuptake Inhibitors; D014196:Trazodone