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A Review of the Evidence for the Efficacy and Safety of Trazodone in Insomnia
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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“Evidence for their efficacy when used alone is relatively weak 38-42 and no specific agent within this group is recommended as preferable to the others in this group.”
From Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults (2008) · cites this paper as [40]
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Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults
Schutte-Rodin, S., Broch, L., Buysse, D., Dorsey, C., & Sateia, M. (2008) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27286 · Cited by 1,943
Control of sleep and wakefulness
Brown, R. E., Basheer, R., McKenna, J. T., Strecker, R. E., & McCarley, R. W. (2012) · Physiological Reviews · doi:10.1152/physrev.00032.2011 · Cited by 1,477
PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder
Gelenberg, A. J., Freeman, P. B., Markowitz, J. C., Rosenbaum, J. F., Thase, M. E., Trivedi, M. H., & Rhoads, R. S. (2010) · Cited by 1,372
Insomnia in the Elderly: A Review
Patel, D., Steinberg, J. D., & Patel, P. J. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7172 · Cited by 742
Espie, C. A., Kyle, S. D., Williams, C., Ong, J. C., Douglas, N. J., Hames, P., & Brown, J. S. L. (2012) · Sleep · doi:10.5665/sleep.1872 · Cited by 550
Metadata
- 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)
- 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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