Efficacy, acceptability, and tolerability of antidepressants for sleep quality disturbances in post-traumatic stress disorder: a systematic review and network meta-analysis

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dc.creatorGabriela de Moraes Costa
dc.creatorPatricia Klarmann Ziegelmann
dc.creatorFabricio Batistin Zanatta
dc.creatorCarolina de Castro Martins
dc.creatorPatricia de Moraes Costa
dc.creatorCarlos Fernando Mello
dc.date.accessioned2024-05-07T19:26:20Z
dc.date.accessioned2025-09-09T00:46:18Z
dc.date.available2024-05-07T19:26:20Z
dc.date.issued2022-07
dc.description.sponsorshipCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
dc.identifier.doihttps://doi.org/10.1016/j.pnpbp.2022.110557
dc.identifier.issn0278-5846
dc.identifier.urihttps://hdl.handle.net/1843/68112
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofProgress in Neuro-Psychopharmacology and Biological Psychiatry
dc.rightsAcesso Restrito
dc.subjectStress disorders, post-traumatic
dc.subjectNetwork meta-analysis
dc.subjectSleep
dc.subjectAntidepressive agents
dc.subject.otherStress disorders
dc.subject.otherPost-traumatic
dc.subject.otherNetwork meta-analysis
dc.subject.otherMultiple treatment comparison meta-analysis
dc.subject.otherSleep
dc.titleEfficacy, acceptability, and tolerability of antidepressants for sleep quality disturbances in post-traumatic stress disorder: a systematic review and network meta-analysis
dc.typeArtigo de periódico
local.citation.spage110557
local.citation.volume117
local.description.resumoSleep 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.
local.publisher.countryBrasil
local.publisher.departmentFAO - DEPARTAMENTO DE ODONTOPEDIATRIA E ORTODONTIA
local.publisher.initialsUFMG
local.url.externahttps://www.sciencedirect.com/science/article/pii/S0278584622000495

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