Treatment Options for Insomnia in Schizophrenia: A Systematic Review

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#eszopiclone #humans #hypnotics-and-sedatives #melatonin #odds-ratio

Treatment Options for Insomnia in Schizophrenia: A Systematic Review

Oliveira et al., 2019 | Pharmacopsychiatry | Systematic Review

Citation

Oliveira Pedro, Coroa Manuel, Madeira Nuno. Treatment Options for Insomnia in Schizophrenia: A Systematic Review. Pharmacopsychiatry. 2019-Jul;52(4):165-169. doi:10.1055/a-0658-1645

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.

Key Findings

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.

Outcomes Measured

  • sleep efficiency
  • insomnia severity

Population

Field Value
Population schizophrenia
Sample Size 4
Age Range See abstract
Condition insomnia

MeSH Terms

  • Eszopiclone
  • Humans
  • Hypnotics and Sedatives
  • Melatonin
  • Odds Ratio
  • Paliperidone Palmitate
  • Schizophrenia
  • Sleep Initiation and Maintenance Disorders

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: melatonin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09