Shahrokhi Maryam, Ghaeli Padideh, Arya Pantea, Shakiba Alia, Noormandi Afsaneh, Soleimani Mehdi, Esfandbod Mohsen
Department of clinical pharmacy, Faculty of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran.
Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Basic Clin Neurosci. 2021 Jan-Feb;12(1):105-114. doi: 10.32598/bcn.12.1.1650.2. Epub 2021 Jan 1.
Patients with cancer may have many complications involving their psychosomatic systems, such as sleep disturbance, depression, and anxiety. Thus, many research studies were conducted to reduce these complications. Zolpidem, as a short-term non-benzodiazepine treatment of insomnia, and melatonin as a chronobiological functionregulatory hormone, are commonly used for improving sleep quality. This randomized clinical trial aims to compare the effects of zolpidem and melatonin on sleep quality, depression, and anxiety in patients with colorectal cancer.
In this single-blinded trial, 90 patients with colorectal cancer undergoing chemotherapy who had obtained a score of 5 or higher on the Pittsburgh Sleep Quality Index (PSQI) were randomly divided into two groups (n=45). One group was treated with 10 mg zolpidem at bedtime, and the other group received 6 mg melatonin at bedtime for 30 days. PSQI on weeks 0, 4, 8, Groningen sleep quality scale, Hamilton rating scale for depression, and Hamilton anxiety rating scale questionnaires were performed to assess patients on weeks 0, 4, and 8. The outcome was then analyzed, and P≤0.05 was considered statistically significant.
Both zolpidem and melatonin had significant impacts on sleep quality in week 4 (P<0.05). After stopping the treatments, the conditions were noticeably reversed on week 8 (P<0.05). Zolpidem and melatonin were relatively similar in affecting sleep duration, latency, efficiency, and disturbance. None of the two study medications had any considerable influence on anxiety and depression.
Melatonin and zolpidem are promising agents for treating sleep complications and, to some extent, depression, and anxiety in cancer patients, according to the present study. However, further clinical trials are recommended to confirm the results of this study.
癌症患者可能会出现许多涉及身心系统的并发症，如睡眠障碍、抑郁和焦虑。因此，人们开展了许多研究来减少这些并发症。唑吡坦作为一种治疗失眠的短期非苯二氮䓬类药物，以及褪黑素作为一种调节生物钟功能的激素，常用于改善睡眠质量。这项随机临床试验旨在比较唑吡坦和褪黑素对结直肠癌患者睡眠质量、抑郁和焦虑的影响。
在这项单盲试验中，90名接受化疗且匹兹堡睡眠质量指数（PSQI）得分在5分或以上的结直肠癌患者被随机分为两组（n = 45）。一组在睡前服用10毫克唑吡坦，另一组在睡前服用6毫克褪黑素，持续30天。在第0、4、8周进行PSQI、格罗宁根睡眠质量量表、汉密尔顿抑郁评定量表和汉密尔顿焦虑评定量表问卷调查，以评估患者在第0、4和8周的情况。然后对结果进行分析，P≤0.05被认为具有统计学意义。
唑吡坦和褪黑素在第4周对睡眠质量均有显著影响（P<0.05）。停止治疗后，第8周情况明显逆转（P<0.05）。唑吡坦和褪黑素在影响睡眠时间、入睡潜伏期、睡眠效率和睡眠障碍方面相对相似。两种研究药物对焦虑和抑郁均无显著影响。
根据本研究，褪黑素和唑吡坦有望用于治疗癌症患者的睡眠并发症，并在一定程度上治疗抑郁和焦虑。然而，建议进一步开展临床试验以证实本研究结果。
