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A Review of the Evidence for the Efficacy and Safety of Trazodone in Insomnia

Mendelson, Wallace B.·2005·The Journal of Clinical Psychiatry

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Abstract

Objective Trazodone, a triazolopyridine antidepressant, is currently the second most commonly prescribed agent for the treatment of insomnia due to its sedating qualities. Given trazodone's widespread use, a careful review of the literature was conducted to assess its efficacy and side effects when given for treatment of insomnia. Data sources In April 2003, a MEDLINE search was conducted using the search terms trazodone and insomnia and trazodone and sleep and restricted to 1980-2003, human subjects, and English language. As trazodone has been implicated in cardiac disorders, a further search was conducted using the term cardiac and trazodone. Study selection All clinical trials that measured any endpoint for insomnia efficacy were included in the assessment. A total of 18 studies were identified from the literature search. In addition, commonly used texts were consulted for information regarding adverse effects related to trazodone. Data extraction Because so few studies were identified by the literature search, all were evaluated and described. Data synthesis Evidence for the efficacy of trazodone in treating insomnia is very limited; most studies are small, conducted in populations of depressed patients, raise issues of design, and often lack objective efficacy measures. Side effects associated with trazodone are not inconsequential, with a high incidence of discontinuation due to side effects, such as sedation, dizziness, and psychomotor impairment, which raise particula…

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Authors: Mendelson, W. B.
Affiliations: University of Chicago (US)
Corresponding author: Mendelson, Wallace B.
Venue: The Journal of Clinical Psychiatry
Publisher: Physicians Postgraduate Press, Inc
Published: 2005-04-15
Volume: 66
Issue: 04
Pages: 469-476
ISSN: 0160-6689 (ISSN-L)
DOI: 10.4088/jcp.v66n0409
OpenAlex: W1963793408
Cited by: 308
References: 0
Citations by year: 2026: 8 · 2025: 13 · 2024: 8 · 2023: 9 · 2022: 5 · 2021: 15 · 2020: 11 · 2019: 12 · 2018: 18 · 2017: 18 · 2016: 7 · 2015: 9 · 2014: 16 · 2013: 9 · 2012: 21
FWCI: 28.51
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords: trazodone, insomnia, antidepressant efficacy, adverse effects, sedation, cardiac side effects, drug tolerance, elderly patients, risk-benefit assessment
MeSH terms: Adult, Age Factors, Aged, Clinical Trials as Topic, Depressive Disorder, Drug Tolerance, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Priapism, Sleep, Trazodone, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Antidepressive Agents, Second-Generation

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A Review of the Evidence for the Efficacy and Safety of Trazodone in Insomnia

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