Effects of trazodone on the sleep of depressed subjects ? a polygraphic study

Abstract

The effects of 400400 mg trazodone on the sleep patterns of ten depressed in-patients treated for 5 weeks were studied during the initial (days 1-3) and terminal (days 26-28) treatment periods. The sleep parameters were compared to those obtained from three sleep recordings performed just prior to the initiation of the treatment and after 2 adaptation nights at the end of a 2-week drug-free period. At the same time, the clinical evolution of patients was evaluated weekly using MADRS and Hamilton-Anxiety scales for anxiety-depression symptomatology and Spiegel and Norris sleep scales. Weekly blood samples were collected to measure plasma levels of trazodone and, at the end of the study, the elimination half-life at steady state was calculated by repeated measurements of plasma levels. Clinical improvement, as assessed by a reduction of more than 60% in MADRS scale scores, was accompanied by evidence of the definitely beneficial effects of trazodone on the disturbed sleep of these depressed patients. From the beginning of treatment, there was a hypnotic-like effect (increase in total duration of sleep and stage II, decrease in sleep latency and intrasleep awakenings). In addition, records at the end of the study showed an increase in delta sleep and an increase in REM latency, an effect classically associated with an antidepressant action. These particularly valuable effects of trazodone on sleep would suggest that this drug should especially be given in cases of depression with major insomnia.

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

“…In our study, the patients did not use trazodone at doses higher than 100 mg/day, which may have contributed to a lower effectiveness when compared to mirtazapine. There appears to be some improvement in sleep parameters with increasing doses of trazodone 6,7,10 . Nierenberg and colleagues reported good in subjective sleep parameters (PSQI -Pittsburgh Index) with the use of 50 mg/day of trazodone while evaluating patients with secondary insomnia with the use of antidepressants 24 .…”

“…Trazodone has proved to be effective in the treatment of sleep disorders in depressed patients (not always older) [6][7][8] , in secondary sleep disorders when compared to other substances 9,10 and in healthy individuals 11 . Assessments of the clinical response to trazodone hydrochloride for the treatment of sleep disorders in demented patients may contribute to the pool of therapeutic options for these patients.…”

Depression and Sleep Disorders: Clinical Relevance, Economic Burden and Pharmacological Treatment

“…This study, however, used substantially lower doses of trazodone than Scharf and Sachais [112] and nearly half the dose of the studies of Mouret et al [111]. Although no laboratory assessment of sleep was included, Jacobsen [114] reported improved subjective sleep with the co-administration of trazodone in 20/21 depressed patients who had MAOI-associated insomnia and 26/27 patients with insomnia but who were treated with other psychotropic medications.…”

“…In an early report, Mouret et al [111] showed no evidence of decreased REM sleep time in 10 depressed patients treated for 5 weeks with trazodone. Sleep assessments were conducted at baseline and again at the end of treatment.…”

Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality

“…The effects of trazodone (400-600 mg) on the sleep patterns of 10 depressed inpatients were studied over a treatment period of 5 weeks [63]. At the beginning of treatment, there was an increase in TST and sleep stage 2 (absolute), and a decrease in sleep stage 1, sleep latency and in the number of awakenings.…”