Trazodone as co-treatment for insomniac patients

Abstract

Introduction Trazodone is an antidepressant belonging to the class of serotonin receptor antagonists and reuptake inhibitors. Trazodone is widely prescribed as a sleep aid, although it is indicated for depression, not insomnia. The aim of this study was to describe the usefulness of trazodone in the treatment of insomnia in our sleep unit. Materials and methods This retrospective cross-sectional study was conducted at a multidisciplinary sleep center (Hospital Universitario Araba) in Vitoria. Patients with insomnia treated with trazodone were analized. Average dose was 11.25±54.9mg (50–300mg). The quantify perceived insomnia severity were then assessed with the Insomnia Severity Index (ISI) questionnaire before and after taking trazodone. The use of benzodiazepine hypnotics, non- benzodiazepine hypnotics, antidepressants and other drugs were picked up on an average time of the intake for 6.1±4.4months. Results From December of 2011 to June of 2013, 166 patients were clinically diagnosed for insomnia, and 40 (24%) of them were started a treatment with trazodone or we added up more dose of it. 37.5% were men and mean age was 53.9±12.9. 33 (82.5%) had comorbid insomnia, and 50% associated with psyquiatric disorder. Compared to pre- treatment, trazodone improved scores on ISI ( p p =0.008). However, there was a increase in the number of non- benzodiazepine hypnotics taken. 13 patients (32.5%) discontinued the trazodone treatment because they did not perceive any benefit with treatment and/or they developed side effects. Conclusion In the group studied, the use of the trazodone could help to reduce the dose of benzodiazepine hypnotics taken. In some cases it could be possible to stop benzodiazepinas and to improve the sleep. One third of the patients discontinued the treatment of trazodone. More studies are necessary to demostrate the risk/benefit ratio for trazodone in insomnia. Acknowledgement All the people that made possible to develop this study.