Please use this identifier to cite or link to this item: 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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