PMID:
J Gen Intern Med. 2019 Jun 3. Epub 2019 Jun 3. PMID: 31161572
Abstract Title:
Prescription Medications for the Treatment of Insomnia and Risk of Suicide Attempt: a Comparative Safety Study.
Abstract:
IMPORTANCE: Guidelines for the pharmacological treatment of chronic insomnia in adults recognize that trazodone and other off-label medications are commonly prescribed despite poor evidence. The Department of Veterans Health Affairs (VA) fills high volumes of inexpensive, over-the-counter sedating antihistamines and older antidepressants in addition to benzodiazepines and zolpidem. Yet little is known about the comparative safety of these agents with regard to suicidal behavior.OBJECTIVES: To assess the comparative effectiveness of the safety of medications routinely used to treat insomnia in VA.DESIGN: Comparative effectiveness using propensity score-matched samples.SETTING: VA.PARTICIPANTS: VA patients without any history of suicidal ideation or behavior 12 months prior to first exposure.EXPOSURES: VA formularies and data were used to identify prescriptions for insomnia. Agents accounting for at least 1% of total insomnia fill volume were
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