Grau-López L, Grau-López L, Daigre C, Palma-Álvarez R F, Rodriguez-Cintas L, Ros-Cucurull E, Roncero C
a Addiction and Dual Diagnosis Unit , Department of Psychiatry , Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM , Barcelona , Spain.
b Department of Psychiatry and Legal Medicine , Universidad Autónoma de Barcelona , Barcelona , Spain.
Subst Use Misuse. 2018 Jul 3;53(8):1267-1274. doi: 10.1080/10826084.2017.1402056. Epub 2017 Nov 29.
Pharmacological treatment of insomnia in patients with addictions has been hardly investigated and there are few researches about it in an inpatient detoxification. The aim of this study was to describe the outcomes of the pharmacological treatment of insomnia in SUD patients admitted to a detoxification unit in Spain, with a focus on the primary substance of abuse and co-occurring mental disorders.
A quasi-experimental study was conducted in 481 addicted in patients, who were admitted for substances detoxification in Vall d´Hebron University Hospital, Barcelona, Spain, from 2010 to 2015. The patients underwent systematic evaluation of axes I and II psychiatric disorders (SCID-I, SCID-II, and CAADID). Insomnia was evaluated using a night time sleep log. Substance-dependent patients, who had insomnia during hospital detoxification, received a psychotropic medication with hypnotic effect, keeping the regular clinical practice without randomization.
At discharge, insomnia was considered to have been alleviated in 63.8% (n = 204) of patients while 36.2% (n = 116) of patients remained with insomnia disturbances. Comparing hypnotic treatments it was observed that mirtazapine and clotiapine were the treatment that corrected the insomnia more frequently.
Since insomnia is not corrected in all patients, it should be further investigated in medications with hypnotic purpose. Based on the results of this work, randomized clinical trials might be proposed.
成瘾患者失眠的药物治疗鲜有研究，在住院戒毒方面相关研究更少。本研究旨在描述西班牙一家戒毒单位收治的物质使用障碍（SUD）患者失眠药物治疗的结果，重点关注主要滥用物质和共病的精神障碍。
对2010年至2015年在西班牙巴塞罗那瓦尔德希伯伦大学医院接受物质戒毒治疗的481名成瘾住院患者进行了一项准实验研究。患者接受了轴I和轴II精神障碍的系统评估（SCID - I、SCID - II和CAADID）。使用夜间睡眠日志评估失眠情况。在医院戒毒期间患有失眠的物质依赖患者接受了具有催眠作用的精神药物治疗，保持常规临床治疗方式，未进行随机分组。
出院时，63.8%（n = 204）的患者失眠被认为得到缓解，而36.2%（n = 116）的患者仍存在失眠困扰。比较催眠治疗发现，米氮平和氯噻平是更常能纠正失眠的治疗方法。
由于并非所有患者的失眠都能得到纠正，因此应进一步研究具有催眠作用的药物。基于本研究结果，可能需要开展随机临床试验。
