Yeung WF, et al. – Doxepin, a sedating tricyclic drug, was recently approved by the U.S. Food and Drug Administration (FDA) at 3 mg and 6 mg doses for the treatment of insomnia. This systematic review evaluated the efficacy and safety of doxepin as a hypnotic. The researchers concluded that low–dose doxepin for 1–2 nights appeared to be safe and effective in improving sleep. However, a clear conclusion on its short–term benefits and risks as well as withdrawal effects was not possible due to the small number of studies. Methods
Researchers searched key databases and trial registers up to March 2014 and contacted pharmaceutical companies and the FDA for unpublished data.
A total of 9 randomized placebo–controlled trials were analyzed.
6 studies were on doxepin 1–6 mg/d, 2 on doxepin 25–300 mg/d, and one on ramelteon 8 mg and doxepin 3 mg combined.
All low–dose studies were industry sponsored.
Low–dose doxepin had a small to medium effect size against placebo for sleep maintenance and sleep duration, but not for sleep initiation, at both immediate and short–term posttreatment.
There was no significant next–day residual effect with low–dose doxepin.
Headache and somnolence were the most common side effects.
Istoric In Romania, in vremea comunismului, pshiatrii au fost incadrati in APR, ramura a celorlalte ramuri medicale.Dupa 1989 APR si-a coninuat prezenta, fiind in continuare condusa de urmasii lui Predescu, Gorgos, Angheluta & co. APR se face vinovat in fata istoriei printr-o selectie mafiotica care a coborit psihiatria romaneasca la un instrument de persecutie a regimului fata deorice aspiratie de innoire,de respingerea a numeroase valori care n-au incaput in breasla si au trebuit sa emigreze sau sa fie marginalizati, perspectiveneavind decit cei hiperadaptati la teroarea raului. Persecutiile fata de psihiatrii si chiar fata de unii bolnavi sunt cunoscute. Text integral