Effects of Trazodone on Sleep: A Systematic Review and Meta-analysis

作者：Maria Kokkali, Elisavet Pinioti, Andreas S. Lappas, Nikolaos Christodoulou, Myrto Samara · 发表于：CNS Drugs · 年份：2024 · DOI：10.1007/s40263-024-01110-2 · 被引用次数：18 · 研究领域：Sleep and related disorders、Sleep and Work-Related Fatigue、Sleep and Wakefulness Research

BACKGROUND AND OBJECTIVES: Sleep problems and insomnia are common, challenging to treat, and transcend specific diagnoses. Although trazodone is a popular choice, robust meta-analytic evidence is lacking. This systematic review and meta-analysis investigates the efficacy and safety of trazodone for sleep disturbances, reflecting recent updates in insomnia diagnosis and treatment. METHODS: We searched Medline, Embase, APA PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 1 May 2024, for Randomized Controlled Trials (RCTs) comparing trazodone with placebo and reporting sleep-related outcomes. The minimum pharmacotherapy duration was 5 days. Included were all RCTs regardless of blinding (open-label or single- or double-blind), while quasi-randomized studies were excluded. The Cochrane Risk of Bias Tool for Randomized Trials assessed bias. Analyses used a random-effects model on an intention-to-treat (ITT) basis. Risk ratio (RR) was used for dichotomous outcomes and weighted mean difference (WMD) for continuous outcomes. When different units or scales were used, Hedge's adjusted g standardized mean difference (SMD) was calculated. Subgroup and preplanned sensitivity analyses explored heterogeneity and evaluated findings' strength and consistency. RESULTS: In total, 44 RCTs with 3935 participants were included. Trazodone did not significan...