[The effectiveness of treatment with trazodone in patients with primary insomnia without and with prior history of hypnotics use].
The treatment of primary insomnia frequently lasts longer than four weeks, the maximal time allowed for daily hypnotics use. Antidepressants are important alternative for long-term insomnia treatment. The aim of the study was compared the efficacy of trazodone in the treatment of patients with primary insomnia with and without prior history of hypnotics use.


METHODS
28 patients (9 M/19 F, mean age 55.9 +/- 11.8) were treated with trazodone, dose 25-150 mg/d, for three months. Before the start of the treatment the patients were observed for seven days without pharmacological treatment to exclude the hypnotics dependency. The Athens Insomnia Scale (AIS), the Sheehan Disability Scale (SDS), the Clinical Global Impression (CGI), the Leeds Sleep Questionnaire (LSEQ) were completed before (Day 0) and after each month of treatment (Day 30, 60, 90). Additionally the patients completed the sleep diaries and two actigraphic recordings for seven days were performed.


RESULTS
The treatment with trazodone decreased the score in the AIS (13.5 +/- 2.4 vs. 6.3 +/- 4.3 points; p < 0.001), increased the sleep time (5.1 +/- 1.3 vs. 6.1 +/- 0.9 hours; p < 0.001) and decreased the sleep latency (82.0 +/- 69.2 vs. 45.9 +/- 41.2 minutes; p < 0.01) from sleep diaries. No significant differences were observed between the patients with and without prior history of hypnotics use. Significant improvement was observed also in all other used scales. Only the actigraphic recordings provided no significant changes during the trazodone treatment.


CONCLUSIONS
Trazodone improves sleep quality and daytime functioning independently from prior history of hypnotics use.
Department of Forensic Medicine, Institute of Psychiatry and Neurology, Warsaw, Poland. wichniak@ipin.edu.pl
Adam
A
Wichniak
Aleksandra
A
Wierzbicka
Anna
A
Sobańska
Eugenia
E
Szatkowska
Krystyna
K
Czasak
Iwona
I
Musińska
Wojciech
W
Jernajczyk
D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D017286:Polysomnography; D012890:Sleep / Q000187:drug effects; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D014196:Trazodone / Q000008:administration & dosage*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives; D014196:Trazodone