SUBJECTIVE HYPNOTIC EFFICACY OF TRAZODONE AND ZOLPIDEM IN DSMIII-R PRIMARY INSOMNIA

Trazodone is an antidepressant which is used at low doses as a hypnoti c. The hypnotic efficacy of trazodone in nondepressed insomniacs is un known, especially in comparison to hypnotic medications such as zolpid em. Following a placebo screening week, DSM-IIIR defined primary insom niacs were randomized into a parallel-group, double-blind, 14-day comp arison of trazodone 50 mg, zolpidem 10 mg and placebo. Patients comple ted daily morning questionnaires and weekly office visits. Self-report ed sleep latencies were compared by the Cox proportional hazards regre ssion technique; self-reported sleep duration by ANOVA. During treatme nt Week 1, both drugs produced significantly shorter self-reported sle ep latencies and longer self-reported sleep durations than placebo. Se lf-reported sleep latency was significantly shorter with zolpidem than with trazodone. During Week 2, only the zolpidem group maintained a s ignificantly shorter sleep latency than the placebo group, and self-re ported sleep duration did not vary significantly among groups. The inc idence of adverse events was low in all groups. Both trazodone and zol pidem improved self-reported sleep latency and duration of non-depress ed, primary insomniacs; zolpidem was somewhat more efficacious at the doses studied. (C) 1998 John Wiley & Sons, Ltd.