title: Comparing Gabapentin with Clonazepam for Residual Sleeping Problems following Antidepressant Therapy in Patients with Major Depressive Disorder: A Randomized Clinical Trial.
abstract: OBJECTIVE
  Residual sleeping disturbances after improvement of depression in major depressed patients are associated with more functional problems, increased relapses and more risk of becoming resistant to treatment. The aim of this study was to compare the efficacy of gabapentin with clonazepam for treating residual sleeping disturbances.
  
  
  METHODS
  This comparative trial was designed as a randomized, controlled, double-blind study. Sixty-three patients with a DSM-IV diagnosis of major depressive disorder (MDD) who had been treated with one of the selective serotonin reuptake inhibitors (SSRIs; fluoxetine, citalopram or sertraline) were included in the study. The patients' depression had improved [Hamilton Depression Rating Scale (HDRS) <10] but they were complaining of sleeping problems [Pittsburgh Sleep Quality Index (PSQI) >5; Insomnia Severity Index (ISI) >8]. Patients were randomized to receive a flexible dose of gabapentin (100-600 mg/day) or clonazepam (0.5-2 mg/day) beside their current antidepressant medication for a period of 4 weeks. Outcome measures were PSQI, ISI and Clinical Global Impression (CGI).
  
  
  RESULTS
  Our results demonstrated that similar to the clonazepam group, sleeping problems improved significantly in the gabapentin group at the end of the trial (PSQI: P = 0.001, Z = 3.549; ISI: P = 0.001, Z = 3.347). The two groups did not show a significant difference in treating residual sleep disturbances (PSQI: P = 0.234, Z = 1.432; ISI: P = 0.456, Z = 1.347).
  
  
  CONCLUSIONS
  This study revealed that gabapentin is comparable to clonazepam for treating sleeping problems associated with major depression.
authors.affiliation: Department of Psychiatry, Substance Abuse and Mental Health Research Center, Hafez Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, mowlaar@gmail.com.
authors.forename: Arash
authors.initials: A
authors.lastname: Mowla
authors.forename: Laaya
authors.initials: L
authors.lastname: Ahmadzadeh
authors.forename: Leila
authors.initials: L
authors.lastname: Razeghian Jahromi
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Dastgheib
mesh_terms: D000328:Adult; D000588:Amines / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002998:Clonazepam / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D012893:Sleep Wake Disorders / Q000188:drug therapy*; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
chemical_list: D000588:Amines; D000928:Antidepressive Agents; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D002998:Clonazepam; D000077206:Gabapentin