Trazodone Improves Sleep Parameters in Alzheimer Disease Patients: A Randomized, Double-Blind, and Placebo-Controlled Study

Camargos, Einstein Francisco; Louzada, Luciana Lilian; Quintas, Juliana Lima; Naves, Janeth O.S.; Louzada, Fernando Mazzilli; Nóbrega, Otávio de Tolêdo

doi:10.1016/j.jagp.2013.12.174

Cited by 140 publications

(89 citation statements)

References 28 publications

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“…One study of trazodone 50 mg at bedtime in AD demonstrated an improvement of 42.5 minutes in total sleep time at night, and there were no significant adverse effects—including cognitive—that were reported[90]. Another study, of mirtazapine 15 mg, found no benefit on sleep after 2 weeks in AD patients, and there was increased daytime sleepiness [91].…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Treatment of Sleep Disorders in Dementia

Ooms

2016

Curr Treat Options Neurol

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Section: Pharmacological Treatmentmentioning

confidence: 99%

Treatment of Sleep Disorders in Dementia

Ooms

2016

Curr Treat Options Neurol

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“…Although no serious adverse effects were reported, overall there was no evidence that melatonin or ramelteon improved sleep outcomes [96–100]. The small study using trazodone at 50 mg nightly for 2 weeks (n = 30 patients) showed modest improvements in total sleep time and sleep efficiency, but did not improve sleep fragmentation, daytime sleep, cognition or activities of daily living [101]. Clearly, there is a dearth of evidence to help guide pharmacological treatment of sleep disturbances in AD.…”

Section: Current Therapiesmentioning

confidence: 99%

The sleep–wake Cycle and Alzheimer’s Disease: What do We know?

Lim

Gerstner

Holtzman

2014

Neurodegener. Dis. Manag.

133

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SUMMARY Sleep–wake disturbances are a highly prevalent and often disabling feature of Alzheimer’s disease (AD). A cardinal feature of AD includes the formation of amyloid plaques, associated with the extracellular accumulation of the amyloid-β (Aβ) peptide. Evidence from animal and human studies suggests that Aβ pathology may disrupt the sleep–wake cycle, in that as Aβ accumulates, more sleep–wake fragmentation develops. Furthermore, recent research in animal and human studies suggests that the sleep–wake cycle itself may influence Alzheimer’s disease onset and progression. Chronic sleep deprivation increases amyloid plaque deposition, and sleep extension results in fewer plaques in experimental models. In this review geared towards the practicing clinician, we discuss possible mechanisms underlying the reciprocal relationship between the sleep–wake cycle and AD pathology and behavior, and present current approaches to therapy for sleep disorders in AD.

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“…These trials could not find evidence that melatonin [20][21][22] or ramelteon [24] , either in immediate-or slow-release form, improved the major sleep outcome in AD patients. Trazodone treatment improved sleep efficiency, but had no effect on the time spent awake after falling asleep or on the number of awakenings at night [23] . Our study indicate that long-term treatment with the low-dose atypical antipsychotic risperidone was effective for the improvement of sleep/wake patterns and the 5-year outcome in AD patients with nocturnal SD, while no significant side effects were noticed.…”

Section: Discussionmentioning

confidence: 86%

“…Only a few randomized controlled trials (RCTs) on drug treatment of SD in AD exist to guide the effective drug treatment of SD with low side effects in AD [10] . Among these are 5 RCTs using 3 different drugs, including melatonin (209 participants, 3 studies, 5-10 mg for 8-10 weeks) [20][21][22] , trazodone (30 participants, 1 study, 50 mg for 2 weeks) [23] , and ramelteon (74 participants, 1 study, 8 mg for 8 weeks) [24] . The melatonin and trazodone RCTs included moderate-to-severe AD patients, whereas mild-to-moderate AD patients were enrolled in the ramelteon trial.…”

Section: Discussionmentioning

confidence: 99%

Low-Dose Atypical Antipsychotic Risperidone Improves the 5-Year Outcome in Alzheimer's Disease Patients with Sleep Disturbances

et al. 2015

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Sleep disturbances (SD) accelerate the progression of Alzheimer's disease (AD) and increase the stress of caregivers. However, the long-term outcome of disturbed nocturnal sleep/wake patterns in AD and on increased stress of spousal caregivers is unclear. This study assessed the 5-year effect of nocturnal SD on the long-term outcome in AD patients. A total of 156 donepezil-treated mild-moderate AD patients (93 AD + SD and 63 AD - SD as a control group) were recruited. The AD + SD patients were formed into 4 subgroups according to the preferences of spousal caregivers for treatment with atypical antipsychotics (0.5-1 mg risperidone, n = 22), non-benzodiazepine hypnotic (5-10 mg zolpidem tartrate, n = 33), melatonin (2.55 mg, n = 9), or no-drug treatment (n = 29). SD were evaluated by polysomnography, sleep scale, and cognitive scale examinations. Moreover, all spousal caregivers of AD patients were assessed using a series of scales, including sleep, anxiety, mood, and treatment attitude scales. Our data showed that nocturnal sleep/wake disturbances were significantly associated with lower 5-year outcomes for AD patients, earlier nursing home placement, and more negative emotions of spousal caregivers. Treatment with low-dose atypical antipsychotic risperidone improved the 5-year outcome in AD + SD patients. In conclusion, low-dose atypical antipsychotic risperidone improves the 5-year outcome in AD patients with SD. Moreover, improvement of nocturnal sleep problems in AD patients will also bring better emotional stability for AD caregivers.

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Trazodone Improves Sleep Parameters in Alzheimer Disease Patients: A Randomized, Double-Blind, and Placebo-Controlled Study

Cited by 140 publications

References 28 publications

Treatment of Sleep Disorders in Dementia

Treatment of Sleep Disorders in Dementia

The sleep–wake Cycle and Alzheimer’s Disease: What do We know?

Low-Dose Atypical Antipsychotic Risperidone Improves the 5-Year Outcome in Alzheimer's Disease Patients with Sleep Disturbances

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