Amitriptyline vs. lorazepam in the treatment of opiate-withdrawal insomnia: a randomized double-blind study

Benzodiazepine use in the treatment of insomnia may cause benzodiazepine dependence, especially in opiate users. The aim of this study was to investigate the sedative-hypnotic effects of amitriptyline in treating opiate-withdrawal insomnia. A total of 27 patients with opiate withdrawal were given either amitriptyline or lorazepam in a randomized double-blind trial. Sleep was assessed by means of the Sleep Evaluation Questionnaire and three insomnia items of the Hamilton Depression Rating Scale. The scores of two sleep measures showed that all aspects of sleep, except for ease of awakening from sleep, in the two treatment groups were not significantly different. In conclusion, apart from the hangover effect, amitriptyline is as effective as lorazepam in the treatment of opiate-withdrawal insomnia.