Senior Psychcare

It's an influential observation, inasmuch as trazodone is widely proscribed in consideration of this aim despite the previous absence of supporting data. The drug is said to be the second most often prescribed for predominant insomnia in the United States (J. Clin. Psychiatry 2005;66:469-76), though this is an off-label use for an agent licensed as an antidepressant, noted Dr. Paterson of the University of Bristol (England).

There is as yet an unmet clinical call for sleep-promoting agents that address deficient sleep quality and concentrate on middle insomnia--awakening in the middle of the night and difficulty falling back asleep--without causing dependency. The polysomnographic study suggests trazodone might deliver consequence toward that conclusion.

Dr. Paterson reported on 12 adults, average age 43 years, with primary chronic insomnia of more than 1 year's duration. All had baseline normal-grade malaise and depression scores. None were on psychotropic or hypnotic medication. They were randomized double blind to 1 night of 100 mg of trazodone or placebo 2 hours in advance of their accustomed repose, after which they underwent home polysomnography. At least 1 week later, they crossed through to the separate research arm.

The 433-minute mean total sleep period in connection with trazodone represented a 38-minute increase over placebo. The mean 129 minutes spent in slow wave sleep during the trazodone night was 33 minutes longer than with placebo. Time spent awake subsequent to slumber outset decreased from 77 minutes on placebo to 57 minutes on trazodone.

Trazodone also significantly curtailed the amount of awakenings while decreasing spindle density, with no change in REM sleep, overall sleep efficiency, or sleep onset, compared with placebo.

Results on the Leeds Sleep Evaluation Questionnaire and the St. Mary's Hospital Sleep Questionnaire showed compelling improvements in subjective sleep factors (quality, satisfaction), compared with placebo. Yet there was no deviation between trazodone and placebo in provisions of "awakening from sleep" or "demeanor following awake," indicating the drug was not associated in association with a significant morning inebriation aftereffect, said Dr. Paterson.

There were 11 adverse events affiliated by means of the lone amount of trazodone, compared together with 3 with placebo. In patients on trazodone, two complained in regard to dizziness; one had a fall; and one each reported clumsiness, nausea, attentional disturbance, or "feeling abnormal." No one had any such complaints when on placebo.

The Avon and Wiltshire Mental Health Partnership NHS Trust funded the research. Dr. Paterson stated no financial conflicts of vested interest.