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http://hdl.handle.net/1843/68112
Type: | Artigo de Periódico |
Title: | Efficacy, acceptability, and tolerability of antidepressants for sleep quality disturbances in post-traumatic stress disorder: a systematic review and network meta-analysis |
Authors: | Gabriela de Moraes Costa Patricia Klarmann Ziegelmann Fabricio Batistin Zanatta Carolina de Castro Martins Patricia de Moraes Costa Carlos Fernando Mello |
Abstract: | Sleep quality disturbances are a common occurrence in post-traumatic stress disorder (PTSD) and may remain after evidence-based treatment for PTSD has been implemented. If left untreated, sleep disturbance can perpetuate or aggravate the disorder. A systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) was conducted comparing efficacy, acceptability, and tolerability among antidepressants for sleep quality improvement in PTSD, using Cochane's RoB2.0 and GRADE approach for NMA. The Cochrane Library, LILACS, PsycINFO, PTSDpubs, and PubMed Central databases were searched from inception to November 29, 2020, leading to the retrieval of 3733 reports. After the selection process, seven RCTs were included in the review (N = 600). We found low certainty of evidence (LCE) that sertraline may improve sleep quality (measured by PSQI) in adult patients with PTSD (MD –0.48, 95% CrI –0.63 to −0.32). Sertraline was as well accepted (RR 1.12, 95% CrI –0.83 to 1.52, very low certainty [VLCE]) and as well tolerated as placebo (RR 0.58, 95% CrI 0.28 to 1.14, LCE). Mirtazapine (MD –3.35, 95% CrI –9.06 to 2.39, LCE), paroxetine (MD –3.13, 95% CrI –7.47 to 1.26, VLCE), nefazodone (MD –0.25, 95% CrI –5.95 to 5.38, VLCE), and bupropion (MD –2.28, 95% CrI –4.75 to 0.21, VLCE) were similar to placebo for improving sleep quality. These antidepressants resulted in little or no benefit for sleep in PTSD. Although the NMA suggested that sertraline may improve sleep in PTSD compared to placebo, due to the low certainty, these estimates are not robust enough to guide clinical decisions. |
Subject: | Stress disorders, post-traumatic Network meta-analysis Sleep Antidepressive agents |
language: | eng |
metadata.dc.publisher.country: | Brasil |
Publisher: | Universidade Federal de Minas Gerais |
Publisher Initials: | UFMG |
metadata.dc.publisher.department: | FAO - DEPARTAMENTO DE ODONTOPEDIATRIA E ORTODONTIA |
Rights: | Acesso Restrito |
metadata.dc.identifier.doi: | https://doi.org/10.1016/j.pnpbp.2022.110557 |
URI: | http://hdl.handle.net/1843/68112 |
Issue Date: | Jul-2022 |
metadata.dc.url.externa: | https://www.sciencedirect.com/science/article/pii/S0278584622000495 |
metadata.dc.relation.ispartof: | Progress in Neuro-Psychopharmacology and Biological Psychiatry |
Appears in Collections: | Artigo de Periódico |
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