title: Treatment of paradoxical insomnia with atypical antipsychotic drugs. A comparison of olanzapine and risperidone.
abstract: OBJECTIVE
  To compare the efficacy of 2 atypical anti-psychotic drugs, olanzapine and risperidone, in the treatment of paradoxical insomnia.
  
  
  METHODS
  In this cross-sectional study over a 2-year period (September 2008 to September 2010), 29 patients with paradoxical insomnia, diagnosed in Kermanshah, Iran by both psychiatric interview and actigraphy, were randomly assigned to 2 groups. For 8 weeks, the first group (n=14) was treated with 10 mg olanzapine daily, and the second group (n=15) was treated with 4 mg risperidone daily. All participants completed the Pittsburgh Sleep Quality Inventory (PSQI) at baseline and at the end of the study.
  
  
  RESULTS
  As expected, a baseline actigraphy analysis showed that total sleep time was not significantly different between the 2 treatment groups (p<0.3). In both groups, sleep quality was improved (p<0.001) with treatment. When comparing the 2 treatments directions, a significant difference emerged (9.21+/-2.35, 6.07+/-4.46) among the 2 treatment groups based on data from the PSQI. Patients who were treated with olanzapine showed greater improvement than patients who were treated by risperidone (p<0.04).
  
  
  CONCLUSIONS
  Atypical anti-psychotic drugs such as olanzapine and risperidone may be beneficial options for treatment of paradoxical insomnia. Larger clinical trials with longer periods of follow-up are needed for further investigation.
authors.affiliation: Sleep Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Habibolah
authors.initials: H
authors.lastname: Khazaie
authors.forename: Leeba
authors.initials: L
authors.lastname: Rezaie
authors.forename: Freshteh
authors.initials: F
authors.lastname: Darvishi
authors.forename: Farid
authors.initials: F
authors.lastname: Najafi
authors.forename: Kristin
authors.initials: K
authors.lastname: Avis
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D001569:Benzodiazepines / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D018967:Risperidone / Q000008:administration & dosage*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D012895:Sleep, REM / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine