Pharmacopsychiatry 2019; 52(04): 165-169
DOI: 10.1055/a-0658-1645
Review
© Georg Thieme Verlag KG Stuttgart · New York

Treatment Options for Insomnia in Schizophrenia: A Systematic Review

Pedro Oliveira
1  Psychiatry Department, Coimbra Hospital University Centre, Coimbra, Portugal
2  Psychological Medicine Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
,
Manuel Coroa
1  Psychiatry Department, Coimbra Hospital University Centre, Coimbra, Portugal
2  Psychological Medicine Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
,
Nuno Madeira
1  Psychiatry Department, Coimbra Hospital University Centre, Coimbra, Portugal
2  Psychological Medicine Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
› Author Affiliations
Further Information

Publication History

received 11 April 2018
revised 07 June 2018

accepted 09 July 2018

Publication Date:
30 July 2018 (eFirst)

Abstract

Background Insomnia is a common feature of schizophrenia. Although several studies have been published about the influence of certain drugs on schizophrenia patients’ sleep, there are no well-grounded recommendations about insomnia treatment in this clinical setting. The present review aimed to identify relevant empirical evidence on available treatments of insomnia in patients with schizophrenia, assessing their safety and efficacy.

Methods This is a systematic review of clinical trials investigating the effect of treatments for insomnia in patients with a diagnosis of schizophrenia. Data were obtained from Medline/PubMed, Embase, PsycInfo, and the Cochrane Library. Risk of bias was assessed in individual studies for selection, performance, detection, attrition, and reporting bias.

Results Four studies met inclusion criteria; 2 using melatonin, 1 using paliperidone, and 1 with eszopiclone. All reported positive results: melatonin increased sleep efficiency and total duration of sleep; paliperidone decreased sleep latency onset and increased total sleep time and sleep efficiency; eszopiclone decreased insomnia severity index.

Conclusions Despite a very limited number of specific studies on this matter, all 4 studies have shown good benefit/risk ratios and reviewed options—melatonin, paliperidone, and eszopiclone—might represent valid options for residual insomnia in schizophrenia.