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Comparing Gabapentin with Clonazepam for Residual Sleeping Problems following Antidepressant Therapy in Patients with Major Depressive Disorder: A Randomized Clinical Trial

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Abstract

Background and Objective

Residual sleeping disturbances after improvement of depression in major depressed patients are associated with more functional problems, increased relapses and more risk of becoming resistant to treatment. The aim of this study was to compare the efficacy of gabapentin with clonazepam for treating residual sleeping disturbances.

Methods

This comparative trial was designed as a randomized, controlled, double-blind study. Sixty-three patients with a DSM-IV diagnosis of major depressive disorder (MDD) who had been treated with one of the selective serotonin reuptake inhibitors (SSRIs; fluoxetine, citalopram or sertraline) were included in the study. The patients’ depression had improved [Hamilton Depression Rating Scale (HDRS) <10] but they were complaining of sleeping problems [Pittsburgh Sleep Quality Index (PSQI) >5; Insomnia Severity Index (ISI) >8]. Patients were randomized to receive a flexible dose of gabapentin (100–600 mg/day) or clonazepam (0.5–2 mg/day) beside their current antidepressant medication for a period of 4 weeks. Outcome measures were PSQI, ISI and Clinical Global Impression (CGI).

Results

Our results demonstrated that similar to the clonazepam group, sleeping problems improved significantly in the gabapentin group at the end of the trial (PSQI: P = 0.001, Z = 3.549; ISI: P = 0.001, Z = 3.347).The two groups did not show a significant difference in treating residual sleep disturbances (PSQI: P = 0.234, Z = 1.432; ISI: P = 0.456, Z = 1.347).

Conclusion

This study revealed that gabapentin is comparable to clonazepam for treating sleeping problems associated with major depression.

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Authors and Affiliations

  1. Department of Psychiatry, Substance Abuse and Mental Health Research Center, Hafez Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

    Arash Mowla, Laaya Ahmadzadeh, Leila Razeghian Jahromi & Seyed Ali Dastgheib

Authors
  1. Arash Mowla
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  2. Laaya Ahmadzadeh
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  3. Leila Razeghian Jahromi
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  4. Seyed Ali Dastgheib
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Corresponding author

Correspondence to Arash Mowla.

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Funding

This study received funding from Grant Number 93-01-34-7907 from Shiraz University of Medical Sciences.

Conflicts of interest

None of the authors have conflicts of interest.

Ethical approval

The study was approved by the ethics committee of the Shiraz University of Medical Sciences that adheres to the Declaration of Helsinki Ethical Principles for Medical Research.

Consent

Written informed consent obtained from all the patients.

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Mowla, A., Ahmadzadeh, L., Razeghian Jahromi, L. et al. Comparing Gabapentin with Clonazepam for Residual Sleeping Problems following Antidepressant Therapy in Patients with Major Depressive Disorder: A Randomized Clinical Trial. Clin Drug Investig 35, 513–517 (2015). https://doi.org/10.1007/s40261-015-0304-8

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  • DOI: https://doi.org/10.1007/s40261-015-0304-8

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