![]() ![]() Considering the high incidence of insomnia in CSVD patients, the results of this preliminary study support the use of low-dose trazodone to deal with insomnia and cognitive impairment in CSVD.Ĭerebral small vessel disease (CSVD) refers to the syndrome of clinical, cognitive, imaging, and pathological manifestations caused by various small vascular diseases ( 1), among which arteriosclerotic CSVD is the most common type ( 1). The improvement of cognition could be achieved by alleviation of insomnia severity. The improvement of sleep quality was correlated with increased concentration and recall abilities.Ĭonclusions: A low dose of trazodone seems acceptable and effective in reducing insomnia severity and improving concentration and recall abilities in this pilot study. ![]() Results: Trazodone caused significantly better improvements in concentration and recall abilities, measured with MoCA, as well as in PSG parameters such as sleep efficiency, N3 sleep ratio, and sleep continuity than the placebo, with no significant differences in the occurrence of side effects. Secondary outcomes included sleep parameters measured with polysomnography (PSG) and the Pittsburgh Sleep Quality Index. The primary outcome was the cognitive score on the Montreal Cognitive Assessment scale (MoCA). Participants were randomized individually to receive either trazodone (study group) or a placebo (control group) for 4 weeks. Forty patients suffering from arteriosclerotic CSVD and insomnia were recruited from an outpatient clinic. Methods: This was a randomized, double-blind, placebo-controlled pilot study. This study was performed to explore the effects of trazodone on sleep quality and cognitive function in CSVD comorbid with chronic insomnia. Low-dose trazodone is effective in treating insomnia, but it is unclear whether it can also improve cognitive function in CSVD patients. 2Department of Neurology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Chinaīackground: Chronic insomnia is common in patients with arteriosclerotic cerebral small vessel disease (CSVD) and aggravates the cognitive impairment caused by CSVD.1Department of Psychiatry, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.All rights reserved.Jihui Wang 1, Sanxin Liu 2, Chongbang Zhao 1, Hongying Han 1, Xiaodong Chen 2, Jiong Tao 1* and Zhengqi Lu 2* Trazodone however, presented good tolerance in the short-term treatment of insomnia.Įfficacy Insomnia Meta-analysis Tolerability Trazodone.Ĭopyright © 2018 Elsevier B.V. ![]() Trazodone was effective in sleep maintenance by decreasing the number of early awakenings and it could significantly improve perceived sleep quality, although there were no significant improvements in sleep efficiency or other objective measures. Moreover, no significant difference was found in the outcome of tolerability or acceptability. As to secondary efficacy outcomes, we only found a significant reduction for trazodone in NAs (SMD = -0.51, 95%CI -0.97 to -0.05) compared to the placebo, with non-significant differences found in SL, TST, or WASO between trazodone and placebo. However, patients receiving trazodone perceived better SQ than those receiving the placebo (SMD = -0.41, 95% CI -0.82 to -0.00, P = 0.05) with a non-significantly moderate heterogeneity (I 2 = 65%, P = 0.06). There was no significant improvement for trazodone in SE% (SMD = 0.09, 95% confidence interval (CI) -0.19 to 0.38, P = 0.53) with a non-significant heterogeneity (I 2 = 0%, P = 0.59). Seven trials involving 429 patients were included. Tolerability outcome was measured by the number of patients who discontinued for adverse events and acceptability outcome was measured by the number of patients who discontinued for all causes. Secondary efficacy outcomes included sleep latency (SL), total sleep time (TST), the number of awakenings (NAs), waking time after sleep onset (WASO). Primary efficacy outcomes included sleep efficiency (SE%) and self-reported sleep quality (SQ). Standardized mean differences (SMD) and the odds ratios (OR) were estimated using a random-effect model. Only randomized placebo-controlled trials were included. ![]() To assess the efficacy and tolerability of trazodone compared with placebo in patients with insomnia.Įlectronic databases were searched and relevant reports were hand-screened to identify eligible trials. ![]()
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