Posted by: admin on: February 27, 2012
Here is an Selective Serotonine Uptake Inhibitor called escitalopram with beneficial effects on both depression and generalized anxiety in terms of insomnia and with least side effects.
Team@CMHF
INTRODUCTION: Disturbed sleep is a key symptom in major depressive disorder (MDD) and generalized anxiety disorder (GAD).First-line antidepressants, including the selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs), may have different effects on sleep.
METHODS: Data from 22 randomized, controlled trials comparing escitalopram with SSRIs, SNRIs, or placebo in the treatment of adult MDD or GAD were included. Both last observation carried forward (LOCF) and repeated measurements (MMRM) were used to analyze the sleep item of the Montgomery Åsberg Depression Rating Scale (MADRS) or Hamilton Anxiety Rating Scale (HAM-A) after 8 weeks of treatment. Sleep-related treatment-emergent adverse events were also compared across groups.
RESULTS: For patients with MDD, the treatment difference on MADRS item 4 (“reduced sleep”) was significantly in favor of escitalopram. For the 53% of patients with MDD who suffered from sleep problems at baseline (baseline MADRS item 4 score ≥4), the improvement in sleep symptoms was significantly in favor of escitalopram For patients with GAD (n=2052) the treatment difference in sleep symptoms measured by HAM-A item 4 (“insomnia”) was significantly in favor of escitalopram , but not different to paroxetine or venlafaxine. The same pattern was seen for the large proportion (67%-82%) of GAD patients reporting sleep problems at baseline. In MDD, the rate of insomnia as an adverse event after escitalopram was higher than placebo, similar to SSRIs, and lower than SNRIs.
CONCLUSIONS: From a clinical perspective, escitalopram appears to be beneficial for the treatment of sleep problems in MDD and GAD.
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