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The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial.

Publication ,  Journal Article
Tek, C; Palmese, LB; Krystal, AD; Srihari, VH; DeGeorge, PC; Reutenauer, EL; Guloksuz, S
Published in: Schizophr Res
December 2014

BACKGROUND: Insomnia is frequent in schizophrenia and may contribute to cognitive impairment as well as overuse of weight inducing sedative antipsychotics. We investigated the effects of eszopiclone on sleep and cognition for patients with schizophrenia-related insomnia in a double-blind placebo controlled study, followed by a two-week, single-blind placebo phase. METHODS: Thirty-nine clinically stable outpatients with schizophrenia or schizoaffective disorder and insomnia were randomized to either 3mg eszopiclone (n=20) or placebo (n=19). Primary outcome measure was change in Insomnia Severity Index (ISI) over 8 weeks. Secondary outcome measure was change in MATRICS Consensus Cognitive Battery (MATRICS). Sleep diaries, psychiatric symptoms, and quality of life were also monitored. RESULTS: ISI significantly improved more in eszopiclone (mean=-10.7, 95% CI=-13.2; -8.2) than in placebo (mean=-6.9, 95% CI=-9.5; -4.3) with a between-group difference of -3.8 (95% CI=-7.5; -0.2). MATRICS score change did not differ between groups. On further analysis there was a significant improvement in the working memory test, letter-number span component of MATRICS (mean=9.8±9.2, z=-2.00, p=0.045) only for subjects with schizophrenia on eszopiclone. There were improvements in sleep diary items in both groups with no between-group differences. Psychiatric symptoms remained stable. Discontinuation rates were similar. Sleep remained improved during single-blind placebo phase after eszopiclone was stopped, but the working memory improvement in patients with schizophrenia was not durable. CONCLUSIONS: Eszopiclone stands as a safe and effective alternative for the treatment of insomnia in patients with schizophrenia. Its effects on cognition require further study.

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Published In

Schizophr Res

DOI

EISSN

1573-2509

Publication Date

December 2014

Volume

160

Issue

1-3

Start / End Page

180 / 185

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Sleep Initiation and Maintenance Disorders
  • Sleep
  • Single-Blind Method
  • Schizophrenic Psychology
  • Schizophrenia
  • Quality of Life
  • Psychotic Disorders
  • Psychiatry
  • Piperazines
 

Citation

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Tek, C., Palmese, L. B., Krystal, A. D., Srihari, V. H., DeGeorge, P. C., Reutenauer, E. L., & Guloksuz, S. (2014). The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial. Schizophr Res, 160(1–3), 180–185. https://doi.org/10.1016/j.schres.2014.10.002
Tek, Cenk, Laura B. Palmese, Andrew D. Krystal, Vinod H. Srihari, Pamela C. DeGeorge, Erin L. Reutenauer, and Sinan Guloksuz. “The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial.Schizophr Res 160, no. 1–3 (December 2014): 180–85. https://doi.org/10.1016/j.schres.2014.10.002.
Tek C, Palmese LB, Krystal AD, Srihari VH, DeGeorge PC, Reutenauer EL, et al. The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial. Schizophr Res. 2014 Dec;160(1–3):180–5.
Tek, Cenk, et al. “The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial.Schizophr Res, vol. 160, no. 1–3, Dec. 2014, pp. 180–85. Pubmed, doi:10.1016/j.schres.2014.10.002.
Tek C, Palmese LB, Krystal AD, Srihari VH, DeGeorge PC, Reutenauer EL, Guloksuz S. The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial. Schizophr Res. 2014 Dec;160(1–3):180–185.
Journal cover image

Published In

Schizophr Res

DOI

EISSN

1573-2509

Publication Date

December 2014

Volume

160

Issue

1-3

Start / End Page

180 / 185

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Sleep Initiation and Maintenance Disorders
  • Sleep
  • Single-Blind Method
  • Schizophrenic Psychology
  • Schizophrenia
  • Quality of Life
  • Psychotic Disorders
  • Psychiatry
  • Piperazines