Treating Insomnia in Schizophrenia: What Are The Options?

Melatonin, paliperidone, and eszopiclone may all be viable treatment options for insomnia among patients with schizophrenia, according to a recent systematic review.

Insomnia is common among patients with schizophrenia. However, there are currently no “well-grounded” recommendations for the treatment of insomnia in this clinical setting, the authors of the review wrote.

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With this in mind, they pooled findings from 4 clinical trials that had assessed the impact of various insomnia treatments among patients with a schizophrenia diagnosis. Databases including Medline/PubMed, Embase, PsycInfo, and the Cochrane Library provided the study data.

Of the 4 studies included, 2 had assessed melatonin, 1 had assessed paliperidone, and 1 had assessed eszopiclone.

All 4 treatment options were shown to have positive effects on patients with schizophrenia. Melatonin was found to help promote sleep efficiency and total duration of sleep, while paliperidone was associated with decreased sleep latency onset and greater total sleep time.

Eszopiclone was also beneficial for insomnia in schizophrenia, helping lower insomnia severity index in this patient population.

“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,” the researchers concluded.

—Christina Vogt

Reference:

Oliveira P, Coroa M, Madeira N. Treatment options for insomnia in schizophrenia: a systematic review [Published online July 30, 2018]. Pharmacopsychiatry. doi:10.1055/a-0658-1645