Objective and subjective sleep quality: Melatonin versus placebo add-on treatment in patients with schizophrenia or bipolar disorder withdrawing from long-term benzodiazepine use
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Objective and subjective sleep quality : Melatonin versus placebo add-on treatment in patients with schizophrenia or bipolar disorder withdrawing from long-term benzodiazepine use. / Baandrup, Lone; Glenthøj, Birte Yding; Jennum, Poul Jørgen.
In: Psychiatry Research, Vol. 240, 30.06.2016, p. 163-9.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Objective and subjective sleep quality
T2 - Melatonin versus placebo add-on treatment in patients with schizophrenia or bipolar disorder withdrawing from long-term benzodiazepine use
AU - Baandrup, Lone
AU - Glenthøj, Birte Yding
AU - Jennum, Poul Jørgen
N1 - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
PY - 2016/6/30
Y1 - 2016/6/30
N2 - Benzodiazepines are frequently long-term prescribed for the treatment of patients with severe mental illness. This prescribing practice is problematic because of well-described side effects including risk of dependence. We examined the efficacy of prolonged-release melatonin on objective and subjective sleep quality during benzodiazepine discontinuation and whether sleep variables were associated with benzodiazepine withdrawal. Eligible patients included adults with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder and long-term use of benzodiazepines in combination with antipsychotics. All participants gradually tapered the use of benzodiazepines after randomization to add-on treatment with melatonin versus placebo. Here we report a subsample of 23 patients undergoing sleep recordings (one-night polysomnography) and 55 patients participating in subjective sleep quality ratings. Melatonin had no effect on objective sleep efficiency, but significantly improved self-reported sleep quality. Reduced benzodiazepine dosage at the 24-week follow-up was associated with a significantly decreased proportion of stage 2 sleep. These results indicate that prolonged-release melatonin has some efficacy for self-reported sleep quality after gradual benzodiazepine dose reduction, and that benzodiazepine discontinuation is not associated with rebound insomnia in medicated patients with severe mental illness. However, these findings were limited by a small sample size and a low retention rate.
AB - Benzodiazepines are frequently long-term prescribed for the treatment of patients with severe mental illness. This prescribing practice is problematic because of well-described side effects including risk of dependence. We examined the efficacy of prolonged-release melatonin on objective and subjective sleep quality during benzodiazepine discontinuation and whether sleep variables were associated with benzodiazepine withdrawal. Eligible patients included adults with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder and long-term use of benzodiazepines in combination with antipsychotics. All participants gradually tapered the use of benzodiazepines after randomization to add-on treatment with melatonin versus placebo. Here we report a subsample of 23 patients undergoing sleep recordings (one-night polysomnography) and 55 patients participating in subjective sleep quality ratings. Melatonin had no effect on objective sleep efficiency, but significantly improved self-reported sleep quality. Reduced benzodiazepine dosage at the 24-week follow-up was associated with a significantly decreased proportion of stage 2 sleep. These results indicate that prolonged-release melatonin has some efficacy for self-reported sleep quality after gradual benzodiazepine dose reduction, and that benzodiazepine discontinuation is not associated with rebound insomnia in medicated patients with severe mental illness. However, these findings were limited by a small sample size and a low retention rate.
KW - Adult
KW - Antipsychotic Agents
KW - Benzodiazepines
KW - Bipolar Disorder
KW - Central Nervous System Depressants
KW - Double-Blind Method
KW - Female
KW - Humans
KW - Male
KW - Melatonin
KW - Middle Aged
KW - Polysomnography
KW - Psychotic Disorders
KW - Schizophrenia
KW - Sleep
KW - Sleep Initiation and Maintenance Disorders
KW - Substance Withdrawal Syndrome
KW - Withholding Treatment
KW - Journal Article
KW - Randomized Controlled Trial
U2 - 10.1016/j.psychres.2016.04.031
DO - 10.1016/j.psychres.2016.04.031
M3 - Journal article
C2 - 27107670
VL - 240
SP - 163
EP - 169
JO - Psychiatry Research
JF - Psychiatry Research
SN - 0165-1781
ER -
ID: 177495209