Neuropsychiatr Dis Treat. 2016 Jun 22;12:1507-15. doi: 10.2147/NDT.S110978. eCollection 2016.
Effect of adjuvant sleep hygiene psychoeducation and lorazepam on depression and sleep quality in patients with major depressive disorders: results from a randomized three-arm intervention.
Neuropsychiatric disease and treatment
Alireza Rahimi, Mohammad Ahmadpanah, Farshid Shamsaei, Fatemeh Cheraghi, Dena Sadeghi Bahmani, Edith Holsboer-Trachsler, Serge Brand
Affiliations
Affiliations
- Behavioral Disorders and Substances Abuses Research Center, Hamadan University of Medial Sciences, Hamadan.
- Research Center for Chronic Disease Care at Home, Hamadan University of Medial Sciences, Hamadan, Iran.
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS).
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS); Department of Sport, Exercise, and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland.
PMID: 27382293
PMCID: PMC4922769 DOI: 10.2147/NDT.S110978
Abstract
BACKGROUND: Sleep disturbances are a common co-occurring disturbance in patients with major depressive disorders (MDDs) and accordingly deserve particular attention. Using a randomized design, we investigated the effects of three different adjuvant interventions on sleep and depression among patients with MDD: a sleep hygiene program (SHP), lorazepam (LOR), and their combination (SHP-LOR).
METHODS: A total of 120 outpatients with diagnosed MDD (mean age: 48.25 years; 56.7% females) and treated with a standard SSRI (citalopram at 20-40 mg at therapeutic level) were randomly assigned to one of the following three conditions: SHP (n=40), LOR (1 mg/d; n=40), SHP-LOR (1 mg/d; n=40). At the beginning and at the end of the study 8 weeks later, patients completed two questionnaires, the Pittsburgh Sleep Quality Index to assess sleep and the Beck Depression Inventory to assess symptoms of depression.
RESULTS: Sleep disturbances decreased over time and in all groups. No group differences or interactions were observed. Symptoms of depression decreased over time and in all three groups. Reduction in symptoms of depression was greatest in the SHP-LOR group and lowest in the LOR group.
CONCLUSION: The pattern of results suggests that all three adjuvant treatments improved symptoms of sleep disturbances and depression, with greater benefits for the SHP-LOR for symptoms of depression, but not for sleep. Nevertheless, risks and benefits of benzodiazepine prescriptions should be taken into account.
Keywords: depression; lorazepam; pharmacotherapy; psychoeducation; sleep disturbances; sleep hygiene
References
- Sleep Med. 2001 Jul;2(4):297-307 - PubMed
- J Clin Psychiatry. 2004;65 Suppl 5:7-12 - PubMed
- Neuropsychiatr Dis Treat. 2016 Mar 07;12:603-7 - PubMed
- Psychiatry Res. 2009 Feb 28;165(3):201-14 - PubMed
- Drugs Context. 2015 Oct 08;4:212290 - PubMed
- BMJ. 2015 Dec 08;351:h6019 - PubMed
- J Psychiatr Res. 2016 Jun;77:27-34 - PubMed
- World J Psychiatry. 2015 Sep 22;5(3):330-41 - PubMed
- Sleep. 2008 Apr;31(4):489-95 - PubMed
- BMC Fam Pract. 2012 May 25;13:40 - PubMed
- J Clin Psychiatry. 2010 Mar;71(3):239-46 - PubMed
- Sleep. 2010 Jan;33(1):97-106 - PubMed
- Dialogues Clin Neurosci. 2008;10(3):329-36 - PubMed
- Pharmacopsychiatry. 2013 May;46 Suppl 1:S30-5 - PubMed
- Biol Psychiatry. 1996 Mar 15;39(6):411-8 - PubMed
- J Consult Clin Psychol. 2008 Jun;76(3):459-67 - PubMed
- EMBO Rep. 2016 Mar;17 (3):296-9 - PubMed
- J Med Invest. 2015 ;62(3-4):204-8 - PubMed
- Int J Mol Sci. 2015 Dec 30;17 (1):null - PubMed
- Ann Med. 2014 Aug;46(5):264-72 - PubMed
- Cochrane Database Syst Rev. 2015 Apr 09;(4):CD010823 - PubMed
- Psychiatr Clin North Am. 2015 Dec;38(4):743-59 - PubMed
- Sleep Med Rev. 2014 Dec;18(6):521-9 - PubMed
- Sleep Med Rev. 2016 Dec;30:1-10 - PubMed
- J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57 - PubMed
- Chronobiol Int. 2013 Jul;30(6):766-71 - PubMed
- J Nerv Ment Dis. 2000 Jan;188(1):53-5 - PubMed
- J Psychosom Res. 2000 Feb;48(2):141-8 - PubMed
- Trials. 2015 Nov 27;16:538 - PubMed
- Ann Clin Psychiatry. 2006 Jan-Mar;18(1):49-56 - PubMed
- Arch Gen Psychiatry. 1961 Jun;4:561-71 - PubMed
- Behav Ther. 2008 Jun;39(2):171-82 - PubMed
- Am J Psychiatry. 2008 Jul;165(7):830-43 - PubMed
- Curr Psychiatry Rev. 2015;11(1):63-83 - PubMed
- JAMA. 2009 May 20;301(19):2005-15 - PubMed
- Sleep. 2015 Dec 01;38(12):1913-26 - PubMed
- Sleep Med Rev. 2006 Oct;10(5):323-37 - PubMed
- Sleep Med Rev. 2009 Jun;13(3):205-14 - PubMed
- J Psychiatr Res. 2004 Sep-Oct;38(5):453-65 - PubMed
- Sleep. 2005 Nov;28(11):1457-64 - PubMed
- Sleep. 2003 Mar 15;26(2):213-6 - PubMed
- J Psychiatr Res. 2010 Mar;44(4):242-52 - PubMed
- J Consult Clin Psychol. 2015 Jun;83(3):564-77 - PubMed
- Behav Sleep Med. 2016 Nov-Dec;14(6):602-14 - PubMed
- Curr Psychiatry Rep. 2009 Dec;11(6):437-42 - PubMed
- Depress Anxiety. 2005;21(4):185-92 - PubMed
- Sleep. 2006 Nov;29(11):1503-6 - PubMed
- Explore (NY). 2009 Jan-Feb;5(1):30-6 - PubMed
- J Clin Psychiatry. 2003 May;64(5):516-23 - PubMed
- Occup Ther Int. 2015 Dec;22(4):195-205 - PubMed
- Biol Psychiatry. 1999 Jan 15;45(2):205-13 - PubMed
- Sleep. 2011 Sep 01;34(9):1155-9 - PubMed
- BMJ Open. 2015 Sep 09;5(9):e007768 - PubMed
- BMC Fam Pract. 2015 Aug 19;16:103 - PubMed
- ScientificWorldJournal. 2015;2015:718607 - PubMed
- Biol Psychol. 2009 Mar;80(3):300-5 - PubMed
- Sleep Med. 2010 Jan;11(1):56-64 - PubMed
- J Clin Psychopharmacol. 2009 Jun;29(3):222-30 - PubMed
- J Clin Psychiatry. 2004;65 Suppl 16:27-32 - PubMed
- Psychiatry Res. 1989 May;28(2):193-213 - PubMed
- J Psychosom Res. 1998 Jul;45(1):5-13 - PubMed
- Br J Clin Psychol. 2000 Sep;39 ( Pt 3):275-86 - PubMed
- Sleep Med Clin. 2015 Mar;10(1):77-84 - PubMed
- J Clin Psychiatry. 2011 Jul;72(7):914-28 - PubMed
- J Affect Disord. 2011 Jun;131(1-3):422-7 - PubMed
- J Clin Psychiatry. 1999 Oct;60(10):668-76 - PubMed
- Behav Med. 2016;42(1):48-56 - PubMed
- Sleep Med. 2014 Sep;15(9):1031-6 - PubMed
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