[The effectiveness of treatment with trazodone in patients with primary insomnia without and with prior history of hypnotics use].

Unlabelled: The treatment of primary insomnia frequently lasts longer than four weeks, the maximal time allowed for daily hypnotics use. Antidepressants are important alternative for long-term insomnia treatment. The aim of the study was compared the efficacy of trazodone in the treatment of patients with primary insomnia with and without prior history of hypnotics use.

Material And Methods: 28 patients (9 M/19 F, mean age 55.9 +/- 11.8) were treated with trazodone, dose 25-150 mg/d, for three months. Before the start of the treatment the patients were observed for seven days without pharmacological treatment to exclude the hypnotics dependency. The Athens Insomnia Scale (AIS), the Sheehan Disability Scale (SDS), the Clinical Global Impression (CGI), the Leeds Sleep Questionnaire (LSEQ) were completed before (Day 0) and after each month of treatment (Day 30, 60, 90). Additionally the patients completed the sleep diaries and two actigraphic recordings for seven days were performed.

Results: The treatment with trazodone decreased the score in the AIS (13.5 +/- 2.4 vs. 6.3 +/- 4.3 points; p < 0.001), increased the sleep time (5.1 +/- 1.3 vs. 6.1 +/- 0.9 hours; p < 0.001) and decreased the sleep latency (82.0 +/- 69.2 vs. 45.9 +/- 41.2 minutes; p < 0.01) from sleep diaries. No significant differences were observed between the patients with and without prior history of hypnotics use. Significant improvement was observed also in all other used scales. Only the actigraphic recordings provided no significant changes during the trazodone treatment.

Conclusion: Trazodone improves sleep quality and daytime functioning independently from prior history of hypnotics use.