Details

Autor(en) / Beteiligte

• de Moraes Costa, Gabriela
• Ziegelmann, Patricia Klarmann
• Zanatta, Fabricio Batistin
• Martins, Carolina Castro
• de Moraes Costa, Patricia
• Mello, Carlos Fernando

Titel

Efficacy, acceptability, and tolerability of antidepressants for sleep quality disturbances in post-traumatic stress disorder: A systematic review and network meta-analysis

Ist Teil von

• Progress in neuro-psychopharmacology & biological psychiatry, 2022-07, Vol.117, p.110557-110557, Article 110557

Ort / Verlag

England: Elsevier Inc

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Sleep quality disturbances are a common occurrence in post-traumatic stress disorder (PTSD) and may remain after evidence-based treatment for PTSD has been implemented. If left untreated, sleep disturbance can perpetuate or aggravate the disorder. A systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) was conducted comparing efficacy, acceptability, and tolerability among antidepressants for sleep quality improvement in PTSD, using Cochane's RoB2.0 and GRADE approach for NMA. The Cochrane Library, LILACS, PsycINFO, PTSDpubs, and PubMed Central databases were searched from inception to November 29, 2020, leading to the retrieval of 3733 reports. After the selection process, seven RCTs were included in the review (N = 600). We found low certainty of evidence (LCE) that sertraline may improve sleep quality (measured by PSQI) in adult patients with PTSD (MD –0.48, 95% CrI –0.63 to −0.32). Sertraline was as well accepted (RR 1.12, 95% CrI –0.83 to 1.52, very low certainty [VLCE]) and as well tolerated as placebo (RR 0.58, 95% CrI 0.28 to 1.14, LCE). Mirtazapine (MD –3.35, 95% CrI –9.06 to 2.39, LCE), paroxetine (MD –3.13, 95% CrI –7.47 to 1.26, VLCE), nefazodone (MD –0.25, 95% CrI –5.95 to 5.38, VLCE), and bupropion (MD –2.28, 95% CrI –4.75 to 0.21, VLCE) were similar to placebo for improving sleep quality. These antidepressants resulted in little or no benefit for sleep in PTSD. Although the NMA suggested that sertraline may improve sleep in PTSD compared to placebo, due to the low certainty, these estimates are not robust enough to guide clinical decisions. •Sleep quality disturbances are frequently observed over the course of PTSD.•This is the first NMA on currently available antidepressants (ADT) for sleep in PTSD.•Balance of benefits and risks of ADT for sleep complaints in PTSD was provided.•There is insufficient relief from sleep quality disturbances with ADT in PTSD.