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Comparison of escitalopram alone and combined with zolpidem in treating major depression and related sleep impairments

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Abstract

Escitalopram has been shown to be effective for treating major depression (MDD); however, research is lacking regarding its effect on treating MDD-related sleep impairments. The purpose of this study was to assess the efficacy of escitalopram monotherapy and investigate changes in insomnia, depressive symptoms, and quality of life (QOL). Participants were 14 patients with MDD who enrolled in a clinical trial at Jikei University Katsushika Medical Center. Escitalopram monotherapy was used, and hypnotics were administered three times per week for individuals suffering from sleep impairments. The following variables were assessed: (1) sleep quality [Pittsburgh sleep quality index (PSQI)], (2) depression [Zung self-rating depression scale (ZSRDS)], and (3) quality of life (QOL) as determined by the Sheehan disability scale (SDISS) and short form (36) health survey (SF-36). These assessments were conducted prior to any treatment (pre-test) and again 8–12 weeks after treatment (post-test). Monotherapy (E = escitalopram alone; n = 6) and combination therapy (E+ = escitalopram + zolpidem; n = 8) groups were compared. All participants completed the full protocol (average 9.4 ± 1.8 weeks). Regardless of treatment group, participants improved on all assessments (including sleep impairment). However, groups did not differ in their level of improvement. A two-factor ANOVA revealed that the E+ group showed particular improvements in QOL. In treating MDD and associated sleep impairments, zolpidem did not confer additional benefits. Thus, clinicians should consider E monotherapy for patients with MDD-related sleep impairments before prescribing combination therapies.

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Acknowledgments

No individuals employed or contracted by the funders (other than the named authors) played any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No funding to report for this study.

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Authors and Affiliations

  1. Department of Psychiatry, The Jikei University Katsushika Medical Center, 6-41-2, Aoto, Katsushika-ku, Tokyo, Japan

    Wataru Yamadera, Michiaki Morita, Satoshi Sakamoto, Ayako Kuroda & Hiroshi Itoh

  2. Department of Psychiatry, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, Japan

    Wataru Yamadera, Michiaki Morita, Satoshi Sakamoto, Ayako Kuroda, Hiroshi Itoh & Kazuhiko Nakayama

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  1. Wataru Yamadera
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  2. Michiaki Morita
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Correspondence to Michiaki Morita.

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Yamadera, W., Morita, M., Sakamoto, S. et al. Comparison of escitalopram alone and combined with zolpidem in treating major depression and related sleep impairments. Sleep Biol. Rhythms 14, 303–308 (2016). https://doi.org/10.1007/s41105-016-0059-5

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  • DOI: https://doi.org/10.1007/s41105-016-0059-5

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