Subjective hypnotic efficacy of trazodone and zolpidem in DSMIII-R primary insomnia

Trazodone is an antidepressant which is used at low doses as a hypnotic. The hypnotic efficacy of trazodone in non-depressed insomniacs is unknown, especially in comparison to hypnotic medications such as zolpidem. Following a placebo screening week, DSM-IIIR defined primary insomniacs were randomized into a parallel-group, double-blind, 14-day comparison of trazodone 50 mg, zolpidem 10 mg and placebo. Patients completed daily morning questionnaires and weekly office visits. Self-reported sleep latencies were compared by the Cox proportional hazards regression technique; self-reported sleep duration by ANOVA. During treatment Week 1, both drugs produced significantly shorter self-reported sleep latencies and longer self-reported sleep durations than placebo. Self-reported sleep latency was significantly shorter with zolpidem than with trazodone. During Week 2, only the zolpidem group maintained a significantly shorter sleep latency than the placebo group, and self-reported sleep duration did not vary significantly among groups. The incidence of adverse events was low in all groups. Both trazodone and zolpidem improved self-reported sleep latency and duration of non-depressed, primary insomniacs; zolpidem was somewhat more efficacious at the doses studied.