Interesting Article from MDLinx

MDLinx  Psychiatry 5 minutes to stay current Your Article Summary Doxepin for Insomnia: A Systematic Review of Randomized Placebo-controlled Trials Sleep Medicine Reviews , 07/29/14 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searched key databases and trial registers up to March 2014 and contacted pharmaceutical companies and the FDA for unpublished data.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. Results 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.