Trazodone for Insomnia: A Systematic Review.

Area of Science:

• Pharmacology
• Sleep Medicine
• Psychiatry

Background:

• Trazodone, an antidepressant, is increasingly used off-label for insomnia.
• Its use for insomnia now exceeds its use for depression.

Purpose of the Study:

• To systematically review the evidence for trazodone's efficacy and safety in treating insomnia.
• To assess trazodone's utility across different insomnia types and patient populations.

Main Methods:

• Conducted a systematic literature search of MEDLINE/PubMed (1983-2016).
• Included randomized clinical trials, meta-analyses, observational studies, and placebo-controlled trials.
• Focused on English language human studies, yielding 45 relevant studies.

Main Results:

• Trazodone demonstrated efficacy for primary and secondary insomnia, including insomnia related to depression and dementia.
• Early studies used higher doses (≥100mg/d) for depressed patients; recent use includes non-depressed individuals.
• Common side effects are dose-dependent, with drowsiness being most frequent.

Conclusions:

• Sufficient evidence supports the efficacy and general safety of low-dose trazodone for insomnia treatment.
• Trazodone is a well-supported option for managing various forms of insomnia.