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Although insomnia increases risks for suicidality, we know little about whether insomnia treatments might be helpful. In a first-ever randomized controlled trial, researchers examined controlled-release (CR) zolpidem or placebo added to open treatment with a selective serotonin reuptake inhibitor (SSRI) in 103 medication-free patients with major depression, insomnia (delayed onset or prolonged awake periods after sleep onset, plus low sleep efficiency), and suicidal ideation (but no plan or intent).
In the 8-week, multisite trial, randomization was conducted with stratification by sex, site, and prior suicide attempt. Zolpidem-CR doses ranged from 6.25 mg to 12.5 mg per night. SSRIs were fluoxetine (20 mg/day), sertraline (50 mg/day) or cita…