title: Evaluation of trazodone and quetiapine for insomnia: an observational study in psychiatric inpatients.
abstract: BACKGROUND
  Insomnia is symptomatic of most psychiatric disorders. Non-habit-forming agents such as trazodone and quetiapine are commonly used off-label to treat patients with insomnia. The safety and efficacy of trazodone and quetiapine as medications for treatment of insomnia have never been directly contrasted. The objective of this study was to compare the effectiveness of trazodone to quetiapine among inpatient psychiatric patients by measuring the traditional sleep parameters of total sleep time, number of nighttime awakenings, sleep efficiency, sleep latency, length of hospitalization, and patient-reported side effects.
  
  
  METHODS
  Participants were recruited from St Helena Hospital Center for Behavioral Health, Vallejo, California. Patient inclusion criteria were age 18 to 65 years, admitted between September 2011 and February 2012, and a physician order for trazodone or quetiapine for insomnia. Exclusion criteria included primary insomnia, pregnancy, concomitant order of trazodone and quetiapine, receiving trazodone or quetiapine up to 2 weeks prior to the study, and inability to coherently communicate. Subjective patient interviews and objective nursing sleep log reviews composed the data set.
  
  
  RESULTS
  On average, mean total sleep time hours were longer among patients receiving trazodone versus those receiving quetiapine according to patients' subjective reports (7.80 vs 6.75, respectively, P < .01) and the nursing sleep logs (9.13 vs 8.68, respectively, P = .04). Patients receiving trazodone experienced fewer mean nighttime awakenings versus those receiving quetiapine (0.52 vs 0.75, respectively, P = .04) according to the nursing sleep log report. Patients receiving trazodone reported more side effects of constipation, nausea, and diarrhea than patients receiving quetiapine.
  
  
  CONCLUSIONS
  With respect to total sleep time and nighttime awakenings, trazodone was a more effective alternative than quetiapine. However, patients receiving trazodone experienced more gastrointestinal patient-reported side effects.
authors.affiliation: College of Pharmacy, Touro University, Vallejo, California (all authors); and School of Pharmacy, West Coast University, Los Angeles, California (Dr Chou).
authors.forename: Shadi
authors.initials: S
authors.lastname: Doroudgar
authors.affiliation: College of Pharmacy, Touro University, Vallejo, California (all authors); and School of Pharmacy, West Coast University, Los Angeles, California (Dr Chou).
authors.forename: Tony I-Fan
authors.initials: TI
authors.lastname: Chou
authors.affiliation: College of Pharmacy, Touro University, Vallejo, California (all authors); and School of Pharmacy, West Coast University, Los Angeles, California (Dr Chou).
authors.forename: Junhua
authors.initials: J
authors.lastname: Yu
authors.affiliation: College of Pharmacy, Touro University, Vallejo, California (all authors); and School of Pharmacy, West Coast University, Los Angeles, California (Dr Chou).
authors.forename: Karen
authors.initials: K
authors.lastname: Trinh
authors.affiliation: College of Pharmacy, Touro University, Vallejo, California (all authors); and School of Pharmacy, West Coast University, Los Angeles, California (Dr Chou).
authors.forename: Jai
authors.initials: J
authors.lastname: Pal
authors.affiliation: College of Pharmacy, Touro University, Vallejo, California (all authors); and School of Pharmacy, West Coast University, Los Angeles, California (Dr Chou).
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Perry