Treatment of insomnia with tricyclic antidepressants: a meta-analysis of polysomnographic randomized controlled trials

Sleep Medicine
Yang LiuYoudong Wei

Abstract

Insomnia represents a significant public health burden worldwide. Antidepressants have often been the insomnia treatment of choice in recent decades. Some tricyclic antidepressants (TCAs) have been shown to improve sleep efficiency. Assess the efficacy and safety of TCAs for the treatment of insomnia using a meta-analysis of randomized control trials (RCTs). Relevant studies were identified in electronic databases such as PubMed, Cochrane, Embase, and Web of Science, up until July 2016. We included all polysomnographic (PSG) RCTs using TCAs to treat insomnia. The primary outcome measure was the total sleep time (TST), although other polysomnographic measures were also investigated. Next-day somnolence and dropout rates were also assessed. The meta-analysis included nine RCTs. TCAs significantly improved TST compared with placebo (SMD = 0.61, 95% CI = 0.50-0.71, P < 0.00001). Participants receiving TCAs were not more likely to drop out than those receiving a placebo because of adverse side effects (1.71% vs 1.19%, RR = 1.37, 95% CI = 0.67-2.80, P = 0.39) or any other reason (7.08% vs 8.20%; RR = 0.86, 95% CI = 0.60-1.23, P = 0.42). However, the incidence of somnolence was higher in participants receiving TCAs (6.06% vs. 3.21%; R...Continue Reading

Citations

May 3, 2019·Expert Opinion on Pharmacotherapy·Elisa BrietzkeClaudio N Soares
Aug 10, 2017·Current Psychiatry Reports·Adam WichniakWojciech Jernajczyk
Feb 9, 2019·Journal of Cellular and Molecular Medicine·Hong FangAnwen Shao
Mar 13, 2021·Translational Research : the Journal of Laboratory and Clinical Medicine·Mark K GreenwaldTimothy A Roehrs
Aug 16, 2021·The Medical Journal of Australia·Alexander SweetmanRobert J Adams

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