Cochrane · systematic review · CD010753
Antidepressants for insomnia in adults
Everitt, H, Baldwin, DS, Stuart, B, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 3 · 25%Low 4 · 33.3%Moderate 5 · 41.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Selective serotonin reuptake inhibitors compared with placebo for insomnia
Population: adults with insomnia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective measures of sleep (quality, duration, sleep onset latency, nocturnal awakenings, sleep, efficiency) (HAM‐D sleep subscale or PSQI at 6 or 12 weeks) Selective serotonin reuptake inhibitors vs placebo | no estimate extracted | 3 studies · 135 participants | Low Downgraded: risk of bias |
Other subjective measures of sleep (total sleep time, sleep onset latency, nocturnal awakenings and subjective sleep efficiency) (PSQI) (at 12 weeks) Selective serotonin reuptake inhibitors vs placebo | no estimate extracted | 1 study · 27 participants | Very low Downgraded: risk of bias |
Adverse events (at 12 weeks) Selective serotonin reuptake inhibitors vs placebo | no estimate extracted | 1 study · 27 participants | Very low Downgraded: risk of bias |
PSG sleep outcomes (at 12 weeks) Selective serotonin reuptake inhibitors vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias |
Tricyclic antidepressants compared with placebo for insomnia
Population: adults with insomnia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective measure of sleep quality (ISI, PSQI) (at 4, 6 or 12 weeks) Tricyclic antidepressants vs placebo | no estimate extracted | 4 studies · 518 participants | Moderate Downgraded: risk of bias |
Adverse events (at 4, 6 or 12 weeks) Tricyclic antidepressants vs placebo | RR 1.02 [0.86, 1.21] | 6 studies · 812 participants | Low Downgraded: risk of bias |
PSG sleep outcomes: sleep latency (at 4 and 12 weeks) Tricyclic antidepressants vs placebo | no estimate extracted | 4 studies · 510 participants | Moderate Downgraded: risk of bias |
PSG sleep outcomes: sleep efficiency (at 4 and 12 weeks) Tricyclic antidepressants vs placebo | no estimate extracted | 4 studies · 510 participants | Moderate Downgraded: risk of bias |
PSG sleep outcomes: total sleep time (at 4 and 12 weeks) Tricyclic antidepressants vs placebo | no estimate extracted | 4 studies · 510 participants | Moderate Downgraded: risk of bias |
'Other' antidepressants compared with placebo for insomnia
Population: adults with insomnia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective measure of sleep quality (PSQI, visual analogue scale or subjective rating of sleep at 6 months or 2 weeks or 7 days) 'Other' antidepressants vs placebo | no estimate extracted | 3 studies · 370 participants | Moderate Downgraded: risk of bias |
Adverse events 'Other' antidepressants vs placebo | no estimate extracted | 2 studies · 217 participants | Low Downgraded: risk of bias |
PSG sleep outcomes: sleep efficiency (at 1 week and 4 weeks 'Other' antidepressants vs placebo | no estimate extracted | 2 studies · 169 participants | Low Downgraded: risk of bias |