Insomnia in depression: Differences in objective and subjective sleep and awakening quality to normal controls and acute effects of trazodone

Saletu-Zyhlarz, Gerda; Abu-Bakr, Manal Hassan; Anderer, P.; Gruber, Georg; Mandl, Magdalena; Strobl, Roland; Gollner, Dietmar; Prause, Wolfgang; Saletu, B.

doi:10.1016/s0278-5846(01)00262-7

Cited by 120 publications

(66 citation statements)

References 65 publications

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“…After 7 weeks they observed no significant changes in sleep initiation and maintenance measures. On the other hand, in our patients with nonorganic insomnia due to depressive episodes and recurrent depression, the same dosage of trazodone (100 mg) induced a significant improvement of sleep efficiency, TSP and TST [43]. Likewise, Mouret et al [44] noted an increase in the total duration of sleep, a decrease in the number of nocturnal awakenings and a shortening of sleep latency in the first night of 100 mg trazodone administration.…”

Section: Discussionsupporting

confidence: 49%

“…The increased PLM index at baseline improved to the normal range under trazodone. In a similar study on major depressive patients 100 mg trazodone had no deteriorating effect on respiratory variables and the PLM index also improved [43].…”

Section: Discussionmentioning

confidence: 80%

“…Previous studies had demonstrated a higher percentage of stage S1 and a reduction in SWS but no differences in sleep stage S2 in dysthymic patients as compared with normal controls [21,23]. Major depressives usually exhibit an increase in light sleep and a decrease in SWS [43,[46][47][48]. When comparing dysthymic and major depressive disorder patients, no significant differences regarding the percentage of S1-4 (including S3 + 4) were observed [24].…”

Section: Discussionmentioning

confidence: 89%

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Insomnia Related to Dysthymia: Polysomnographic and Psychometric Comparison with Normal Controls and Acute Therapeutic Trials with Trazodone

et al. 2001

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Utilizing polysomnography (PSG) and psychometry, objective and subjective sleep and awakening quality was investigated in 11 patients (mean age 50 ± 14) with nonorganic insomnia (F 51.0) related to dysthymia (F 34.1) as compared with 11 age- and sex-matched normal controls. Patients demonstrated decreased sleep efficiency and sleep stage S2 as well as increased sleep latency to S1, S2 and S3, wakefulness within the total sleep period, number of awakenings, S1 and REM sleep. There was no intergroup difference in REM latency. Subjective sleep quality and the total score of the Self-Assessment Scale for Sleep and Awakening Quality (SSA) were deteriorated as were evening and morning well-being, mood, affectivity and drowsiness. Noopsychic measures showed deteriorated numerical memory, fine motor activity and reaction time variability. In a placebo-controlled crossover design study, the acute effects of 100 mg trazodone¹, a serotonin reuptake inhibitor with a sedative action due to 5HT₂ and α₁ receptor blockade, were investigated in the patients. As compared with placebo, trazodone induced an increase in slow-wave sleep (S3 + 4), a lengthening of REM latency, a decrease in REM sleep and a normalization of the periodic leg movement (PLM) index. In the morning, there was a minimal increase in somatic complaints and a decrease in critical flicker frequency and systolic blood pressure. In conclusion, our study demonstrated that dysthymia induced significant changes in objective and subjective sleep and awakening quality, which were counteracted by 100 mg trazodone, thus suggesting a key-lock principle in the treatment of nonorganic insomnia related to dysthymia with this drug.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 89%

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Insomnia Related to Dysthymia: Polysomnographic and Psychometric Comparison with Normal Controls and Acute Therapeutic Trials with Trazodone

et al. 2001

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“…80 The choice of antidepressant should be carefully considered, as SSRIs and SNRIs may exacerbate RLS symptoms. Atypical antidepressants such as bupropion, 30,117,118 trazodone, 119 and nefazodone 120 do not appear to exacerbate PLMS and may be suitable therapies. Other drugs that may worsen or induce RLS symptoms include the atypical antipsychotics quetiapine, [121][122][123] risperidone, 124 and olanzapine.…”

Section: Pharmacologic Treatment For Rlsmentioning

confidence: 99%

Mood Disorders in Restless Legs Syndrome (Willis-Ekbom Disease)

Becker¹,

Sharon²

2014

J. Clin. Psychiatry

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Study Selection: 173 publications were retrieved. Articles related to the association between idiopathic RLS and depression, anxiety, and mood disorders were reviewed. In total, 32 epidemiologic studies were identified. These studies were reviewed in detail and ranked according to quality.Data Extraction: Data were extracted on the basis of relevance to the topic. Epidemiologic studies were assessed using 3 parameters: methodology, data quality, and generalizability of the results. Each factor was scored from 1 (high quality) to 4 (low quality), giving a total score of between 3 and 12 for each study.Results and Conclusions: RLS and mood disorders are frequently comorbid. Recognition and appropriate treatment of comorbid RLS are particularly important in patients with psychiatric disorders, as RLS is a common medical reason for insomnia, and antidepressant use may exacerbate sensory symptoms.

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“…Saletu-Zyhlarz and collaborators, using polysomnography, evaluated 11 individuals with depression and sleep disorders and compared them to 11 healthy subjects. The authors observed an improvement in sleep parameters with the use of 100 mg/day of trazodone 23 . There was an increase in sleep total time, as we well as a reduction in nighttime and early awakenings.…”

Section: Discussionmentioning

confidence: 94%

Trazodone for the treatment of sleep disorders in dementia: an open-label, observational and review study

Camargos¹,

Pandolfi²,

Freitas

et al. 2011

Arq. Neuro-Psiquiatr.

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Sleep disorders (SD) in patients with dementia are very common in clinical practice. The use of antidepressants with hypnotic actions, such as trazodone, plays an important role in these cases. The aim of this study is to present a profile of the use of trazodone in demented patients with SD, as well as a review of trazodone hydrochloride in SD. We evaluated 178 elderly patients with Alzheimer's disease and other dementias, clinically presenting SD and treated with hypnosedative medications. In the one-year period comprising the study, 68 (38.2%) of the 178 had sleep disorders. Most patients (114; 64%) had a diagnosis of Alzheimer's disease. Approximately 85% of patients with SD used hypnosedative drugs. Trazodone was the most commonly used drug among patients (N = 35), with an effectiveness of 65.7%. Trazodone has been shown to be a good option for treatment of the elderly with dementia and associated SD. Key words: sleep, dementia, Alzheimer's disease, trazodone, antidepressant.Trazodona para o tratamento de distúrbios do sono em demência: um estudo aberto, observacional e de revisão RESUMO Distúrbios do sono (DS) em pacientes com demência são muito comuns na prática clínica. O uso de antidepressivos com ação hipnótica, como a trazodona, tem um papel importante nesses casos. O objetivo desse estudo é apresentar um perfil do uso da trazodona em pacientes com demência e com DS, bem como revisar o cloridrato de trazodona no DS. Nós avaliamos 178 idosos com doença de Alzheimer (DA) e outras demências, clinicamente apresentando DS e que foram tratados com medicações hipnossedativas. No período de um ano de estudo, 68 (38,2%) tiveram DS. A maioria (114; 64%) tinham diagnóstico de DA. Aproximadamente 85% usaram fármacos hipnossedativos. A trazodona foi a mais utilizada (N=35), com evidência de melhora de 65,7%. A trazodona mostrou-se ser uma boa opção no tratamento de idosos com demência e DS associado. Palavras-chave: sono, demência, doença de Alzheimer, trazodona, antidepressivos.

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Insomnia in depression: Differences in objective and subjective sleep and awakening quality to normal controls and acute effects of trazodone

Cited by 120 publications

References 65 publications

Insomnia Related to Dysthymia: Polysomnographic and Psychometric Comparison with Normal Controls and Acute Therapeutic Trials with Trazodone

Insomnia Related to Dysthymia: Polysomnographic and Psychometric Comparison with Normal Controls and Acute Therapeutic Trials with Trazodone

Mood Disorders in Restless Legs Syndrome (Willis-Ekbom Disease)

Trazodone for the treatment of sleep disorders in dementia: an open-label, observational and review study

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