title: Insomnia treatment in the third trimester of pregnancy reduces postpartum depression symptoms: a randomized clinical trial.
abstract: Mental health is an important medical issue in perinatal care, and there is increasing evidence that insomnia during pregnancy is associated with postpartum depression (PPD). Therefore, the present study evaluated the effect of insomnia treatment during the third trimester of pregnancy on PPD symptoms. Fifty-four pregnant women with insomnia were randomly assigned to trazodone, diphenhydramine, or placebo treatment. Sleep quality was measured by actigraphy at baseline, and after 2 and 6 weeks of treatment. In addition, depression was assessed 2 and 6 weeks after delivery. Trazodone and diphenhydramine improved sleep profile compared to placebo after 6 weeks of treatment. Further, depressive symptoms were reduced 2 and 6 weeks after delivery in trazodone and diphenhydramine groups compared to placebo. No differences in depressive symptoms were observed between the trazodone and diphenhydramine groups. These findings indicate that insomnia treatment with trazodone or diphenhydramine during the third trimester of pregnancy may prevent PPD.
authors.affiliation: Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
authors.forename: Habibolah
authors.initials: H
authors.lastname: Khazaie
authors.forename: Mohammad Rasoul
authors.initials: MR
authors.lastname: Ghadami
authors.forename: David C
authors.initials: DC
authors.lastname: Knight
authors.forename: Farnoosh
authors.initials: F
authors.lastname: Emamian
authors.forename: Masoud
authors.initials: M
authors.lastname: Tahmasian
mesh_terms: D056044:Actigraphy; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D019052:Depression, Postpartum / Q000517:prevention & control*; D004155:Diphenhydramine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D011263:Pregnancy Trimester, Third; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012890:Sleep / Q000187:drug effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000209:etiology; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000523:psychology; D014196:Trazodone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D004155:Diphenhydramine; D014196:Trazodone
keywords: Diphenhydramine; Insomnia; Postpartum depression; Sleep disorders; Trazodone