Study designs of evaluations included in the review
Randomised controlled trials (RCTs) with a minimum of 5 patients per group, and which were double-blind, were eligible for inclusion in the review. The duration of the included studies ranged from 3 days to 1 year.
Specific interventions included in the review
Studies of antidepressant drugs were eligible for inclusion. Eligible studies used placebo or alternative antidepressants as the comparator interventions. The included studies considered the following classes of antidepressants: tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), selective serotonin re-uptake inhibitors (SSRIs) and others. The individual antidepressants used in the included studies were: amitriptyline, paroxetine, milnacipran, fluoxetine, moclobemide, sertraline, befloxatone, lorazepam, mirtazapine, imipramine, alprazolam, trazodone, femoxetine, maprotiline, fluvoxamine, brofaromine, trimipramine, citalopram, lormetazepam, nortiptyline, doxepin, bupropion, toloxatone, mianserin, nefazodone, dothiepin, zolpedim, buspirone, nomifensine, clobazam, melitracen, flupentixol, maprotiline and venlafaxine.
Participants included in the review
Studies of patients taking antidepressant medications were eligible for inclusion. Both individuals with depression and those being treated for other conditions were eligible for inclusion. The included studies involved healthy volunteers and patients with the following conditions: fibromyalgia, cancer, bruxism, depression, opiate withdrawal, marijuana withdrawal, alcohol dependence, gastric conditions, rheumatism, hip or knee arthroplasty, chronic or severe pain, panic or agoraphobia, insomnia with or without depression, conditions related to geriatric status, and manic depression with psychosis. Both in- and out-patients were included. A number of studies had elderly populations. Both male and female participants were included.
Outcomes assessed in the review
Studies reporting sleep-related outcomes were eligible for inclusion. The included studies reported outcomes such as disturbed sleep, drowsiness, sedation and difficulty waking, alertness, arousal, rapid eye movement (REM) sleep, insomnia, early morning waking, sleep quality, slow-wave sleep, total sleep time, sleep efficiency, sleep latency, waking after sleep onset, and length of such awakenings. Other outcomes, including depression and anxiety, were also reported.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.