Evidence map›Paper›PMID 37048577›Full record

ReviewJournal of clinical medicine2023

Alliance for Sleep Clinical Practice Guideline on Switching or Deprescribing Hypnotic Medications for Insomnia.

Nathaniel F Watson, Ruth M Benca, Andrew D Krystal, William V McCall, David N Neubauer

Registry-linked trialOpen access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07555743 (Efficacy and Safety of Daridorexant in Patients With Major Depressive Disorder), which is not on this map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
10.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07555743 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Efficacy and Safety of Daridorexant in Patients With Major Depressive Disorder (MDD) and Insomnia: Double-blind, Randomized, Controlled Trial

TypeinterventionalSponsorInstitut d'Investigació Biomèdica de BellvitgeRan2026 to 2028Enrolled134ConditionsInsomnia, Major Depressive DisorderArmsDaridorexant 50 mg, Placebo
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 1 country.

Nathaniel F WatsonDepartment of Neurology, University of Washington School of Medicine, Seattle, WA 98195, USA.ORCID 0000-0003-4870-080X
Ruth M BencaDepartment of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA.
Andrew D KrystalDepartment of Psychiatry and Neurology, UCSF Weill Institute for Neurosciences, San Francisco, CA 94158, USA.
William V McCallDepartment of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.ORCID 0000-0001-5035-7858
David N NeubauerDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA.
Augusta University · USJohns Hopkins University · USNeurosciences Institute · USUniversity of Washington · USWake Forest University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Determining the most effective insomnia medication for patients may require therapeutic trials of different medications. In addition, medication side effects, interactions with co-administered medications, and declining therapeutic efficacy can necessitate switching between different insomnia medications or deprescribing altogether. Currently, little guidance exists regarding the safest and most effective way to transition from one medication to another. Thus, we developed evidence-based guidelines to inform clinicians regarding best practices when deprescribing or transitioning between insomnia medications. Five U.S.-based sleep experts reviewed the literature involving insomnia medication deprescribing, tapering, and switching and rated the quality of evidence. They used this evidence to generate recommendations through discussion and consensus. When switching or discontinuing insomnia medications, we recommend benzodiazepine hypnotic drugs be tapered while additional CBT-I is provided. For Z-drugs zolpidem and eszopiclone (and not zaleplon), especially when prescribed at supratherapeutic doses, tapering is recommended with a 1-2-day delay in administration of the next insomnia therapy when applicable. There is no need to taper DORAs, doxepin, and ramelteon. Lastly, off-label antidepressants and antipsychotics used to treat insomnia should be gradually reduced when discontinuing. In general, offering individuals a rationale for deprescribing or switching and involving them in the decision-making process can facilitate the change and enhance treatment success.

Indexed as

deprescribinghypnoticsinsomniainsomnia medicationsswitching

Identifiers

PMID37048577
PMCPMC10095217
OpenAlexW4361007887

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.