Karim Yahia Jaffer1, Tiffany Chang1, Brigitte Vanle1, Jonathan Dang1, Alexander J Steiner1, Natalie Loera1, Marina Abdelmesseh1, Itai Danovitch1, Waguih William Ishak1. 1. Mr. Jaffer is with the Faculty of Medicine, Cairo University, Egypt. Ms. Chang is with the University of California Los Angeles, Los Angeles, California. Dr. Vanle, Dr. Dang, Ms. Loera, Dr. Abdelmesseh, and Dr. Danovitch are with the Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California. Dr. Steiner is with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California. Dr. IsHak is with the Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California, and the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
Abstract
OBJECTIVE: While trazodone is approved for the treatment of depression, the off-label use of this medication for insomnia has surpassed its usage as an antidepressant. In this systematic review, we examined the evidence for the efficacy and safety of trazodone for insomnia. METHODS: A literature search was conducted using MEDLINE/PubMed databases from the past 33 years (1983-2016) and the keywords insomnia, trazodone, sedative, treatment, and hypnotics. The results were restricted to English language and human subjects. All randomized clinical trials, meta-analyses, observational studies, and placebo-controlled trials regarding trazodone for the treatment of primary or secondary insomnia were reported, per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The study selection process yielded a total of 45 studies. RESULTS: Evidence for the efficacy of trazodone has been repeatedly demonstrated for primary insomnia, as well as secondary insomnia, including for symptoms that are a result of depression, dementia, and being a healthy man. Earlier studies (1980-2000) focused on utilizing trazodone at high doses (≥100mg/d) for the treatment of insomnia among the depressed population; however, since the 2000s, the utility of trazodone has been expanded to treat secondary insomnia among the non-depressed population as well. The side effects are dose-dependent, and the most common is drowsiness. CONCLUSION: A review of the literature suggests that there are adequate data supporting the efficacy and general safety of the low-dose use of trazodone for the treatment of insomnia.
OBJECTIVE: While trazodone is approved for the treatment of depression, the off-label use of this medication for insomnia has surpassed its usage as an antidepressant. In this systematic review, we examined the evidence for the efficacy and safety of trazodone for insomnia. METHODS: A literature search was conducted using MEDLINE/PubMed databases from the past 33 years (1983-2016) and the keywords insomnia, trazodone, sedative, treatment, and hypnotics. The results were restricted to English language and human subjects. All randomized clinical trials, meta-analyses, observational studies, and placebo-controlled trials regarding trazodone for the treatment of primary or secondary insomnia were reported, per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The study selection process yielded a total of 45 studies. RESULTS: Evidence for the efficacy of trazodone has been repeatedly demonstrated for primary insomnia, as well as secondary insomnia, including for symptoms that are a result of depression, dementia, and being a healthy man. Earlier studies (1980-2000) focused on utilizing trazodone at high doses (≥100mg/d) for the treatment of insomnia among the depressed population; however, since the 2000s, the utility of trazodone has been expanded to treat secondary insomnia among the non-depressed population as well. The side effects are dose-dependent, and the most common is drowsiness. CONCLUSION: A review of the literature suggests that there are adequate data supporting the efficacy and general safety of the low-dose use of trazodone for the treatment of insomnia.
Authors: Thomas Schwartz; Nikhil Nihalani; Subhdeep Virk; Shefali Jindal; Anne Costello; Ray Muldoon; Nouman Azhar; Juhi Hussein; Syed Tirmazi Journal: Int J Psychiatr Nurs Res Date: 2004-08
Authors: Judith Sys; Simon Van Cleynenbreugel; Mieke Deschodt; Lorenz Van der Linden; Jos Tournoy Journal: Eur J Clin Pharmacol Date: 2019-12-14 Impact factor: 2.953
Authors: Scott Maresh; Joel Prowting; Sarah Vaughan; Elizabeth Kruppe; Bander Alsabri; Hossein Yarandi; M Safwan Badr; Abdulghani Sankari Journal: J Appl Physiol (1985) Date: 2020-08-20
Authors: Jennifer J Dorsch; Jennifer L Martin; Atul Malhotra; Robert L Owens; Biren B Kamdar Journal: Semin Respir Crit Care Med Date: 2019-12-11 Impact factor: 3.119
Authors: S M Romanella; D Roe; E Tatti; D Cappon; R Paciorek; E Testani; A Rossi; S Rossi; E Santarnecchi Journal: Sleep Med Date: 2020-05-30 Impact factor: 3.492
Authors: Alexandros N Vgontzas; Kristina Puzino; Julio Fernandez-Mendoza; Venkatesh Basappa Krishnamurthy; Maria Basta; Edward O Bixler Journal: J Clin Sleep Med Date: 2020-12-15 Impact factor: 4.062