Journal of Pharmaceutical Care 2016. 4(3-4):52-57.

Comparing Effects of Melatonin versus Trazodone on Sleep Quality in Major Depressed Patients Receiving Sertraline
Zahra Mirsepassi, Shima Saedi, Haleh Behpournia, Behrang Shadloo, Valentin Artounian, Seyyed Taha Yahyavi, Maryam Tabatabaei, Mehdi Soleimani, Sana Khajehpour, Padideh Ghaeli

Abstract


Background_ Sleep disturbance is a common complaint in major depressive disorder (MDD) including impairment of both subjective and objective parameters, Also SSRIs as antidepressant drugs can affect sleep architecture (SA).

Aim _This randomized trial was designed to compare the effects of trazodone with melatonin on sleep quality (SQ) of patients with MDD based on Diagnostic and Statistical Manual for Mental Disorders –5th edition (DSM-5) criteria.

Method_ Sixty patients who have the study criteria were entered in this study and were divided into two groups receiving either trazodone or melatonin. They were evaluated for sleep quality and depression severity by using Pittsburgh Sleep Quality Index (PSQI) and Hamilton Depression Rating Scale (HAM-D) at baseline and after 4 and 8 weeks.

Result_ Thirty two patients complete the study. Fourteen patients received 3mg of melatonin and eighteen patients received 50mg of trazodone before sleep time. After 4 and 8 weeks treatment with melatonin or Trazodone, significant improvements in SQ were showed in both groups. Additionally, a significant reduction in sleep latency (SL) was showed after 4 weeks of treatment with melatonin but not with trazodone.

Conclusion_ This study demonstrated that both Melatonin and Trazodone improved SQ in outpatients with MDD after 8 weeks of treatment but melatonin created greater reduction in SL than trazodone after 4 weeks.


Keywords


Melatonin; Trazodone; Depression; Sleep Quality; Pittsburgh Sleep Quality Index

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References


Murphy MJ, Peterson MJ. Sleep Disturbances in Depression. Sleep MedClin 2015;10(1):17-23.

Palagini L, Baglioni C, Ciapparelli A, Gemignani A. Riemann DREM sleep dysregulation in depression: state of the art. Sleep Med Rev2013;17(5):377-90.

Oberndorfer S, Saletu-Zyhlarz G, Saletu B. Effects of selectiveserotonin reuptake inhibitors on objective and subjective sleep quality.Neuropsychobiology 2000;42(2):69-81.

Kaynak H, Kaynak D, Gözükırmızı E, Guilleminault C. The effects oftrazodone on sleep in patients treated with stimulant antidepressants. SleepMed 2004;5(1):15-20.

Cardinali DP, Srinivasan V, Brzezinski A, Brown GM. Melatonin and itsanalogs in insomnia and depression. J Pineal Res012;52(4):365-75.

Lemoine P, Nir T, Laudon M, Zisapel N. Prolonged-release melatoninimproves sleep quality and morning alertness in insomnia patients aged 55years and older and has no withdrawal effects. J Sleep Res 2007;16(4):372-80.

Saletu-Zyhlarz GM, Abu-Bakr MH, Anderer P, et al. Insomnia in depression:differences in objective and subjective sleep and awakening quality tonormal controls and acute effects of trazodone. Prog NeuropsychopharmacolBiol Psychiatry 2002;26(2):249-60.

Buysee D, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The PittsburghSleep Quality Index: a new instrument for psychiatric practice and research.Psychiatry Res. 1989;28(2):193-213.

Rush AJ, Trivedi MH, Ibrahim HM, et al. The 16-Item Quick Inventory ofDepressive Symptomatology (QIDS), clinician rating (QIDS-C), and selfreport(QIDS-SR): a psychometric evaluation in patients with chronic majordepression. Biol Psychiatry 2003;54(5):573-83.

Hughes RJ, Sack RL, Lewy AJ. The role of melatonin and circadian phasein age-related sleep-maintenance insomnia: assessment in a clinical trial ofmelatonin replacement. Sleep 1998;21(1):52-69.

Brzezinski A, Vangel MG, Wurtman RJ, et al. Effects of exogenousmelatonin on sleep: a meta-analysis. Sleep Med Rev 005;9(1):41-50.

Leppämäki S, Partonen T, Vakkuri O, Lönnqvist J, Partinen M, Laudon M.Effect of controlled-release melatonin on sleep quality mood, and qualityof life in subjects with seasonal or weatherassociated changes in mood andbehaviour. Eur Neuropsychopharmacol. 2003;13(3):137-45.

Mayers AG, Baldwin DS. Antidepressants and their effect on sleep. HumPsychopharmacol 2005;20(8):533-59.

Zavesicka L, Brunovsky M, Horacek J, et al. Trazodone improves theresults of cognitive behaviour therapy of primary insomnia in non-depressedpatients. Neuro Endocrinol Lett 2008;29(6):895-901.


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