The effect of low doses of mirtazapine and quetiapine on sleep and daytime functioning

ISRCTN ISRCTN20011041
DOI https://doi.org/10.1186/ISRCTN20011041
EudraCT/CTIS number 2013-003460-31
Secondary identifying numbers NL46501.075.13
Submission date
30/03/2016
Registration date
31/03/2016
Last edited
29/01/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Sleep is an essential requirement for life, and is vital for people to be able to function. Many people in the general population have trouble falling or staying asleep, or do not feel refreshed after sleeping. Around 30% of otherwise healthy people experience these kinds of sleep difficulties (insomnia) and in those suffering from mental health problems, this number is even higher. Insomnia is often treated using sedatives (benzodiazepines), however these are very addictive and can have unwanted side effects, such as feeling tired and sleepy during the day. In many cases, low doses of alternative drugs which have sedating properties are prescribed, such as mirtazapine (antidepressant), or quetiapine (antipsychotic medication). Although many doctors observe improvement in patients treated this way, there are few studies which support the effectiveness of low doses of mirtazapine or quetiapine for the treatment of insomnia. The aim of this study is to investigate the effects of 7.5mg mirtazapine and 50mg quetiapine on sleep and daytime functioning.

Who can participate?
Healthy men aged between 18 and 35 who usually go to bed between 10pm and midnight and sleep between 6.5 to 8.5 hours a night.

What does the study involve?
Participants sleep at the sleep center of GGZ Drenthe on three consecutive nights, for three consecutive weeks. Each week participants take a different medication, the order of which is random. Night one of each week is considered an adaptation night, when participants can adapt to sleeping in the unfamiliar surroundings. On nights two and three of each week, participants are asked to take a capsule containing 7.5mg mirtazapine, 50mg quetiapine, or a placebo (dummy pill) 30 minutes before they go to bed. During the night, participants have their sleep monitored by a machine that records brain waves, blood oxygen levels, heart rate, breathing and eye and leg movement (polysomnography). Each morning, participants are asked to fill out questionnaires about their quality of sleep and current sleepiness and complete tasks on a computer which measure their reaction time (movement associated with mental processes).

What are the possible benefits and risks of participating?
There are no direct benefits of taking part although participants will receive financial compensation. There is a small risk of experiencing side effects from the study medications, such as sleepiness during the day or dizziness.

Where is the study run from?
GGZ Drenthe (Netherlands)

When is the study starting and how long is it expected to run for?
January 2014 to September 2015

Who is funding the study?
GGZ Drenthe (Netherlands)

Who is the main contact?
Dr Julie Karsten

Contact information

Dr Julie Karsten
Scientific

GGZ Drenthe
Dennenweg 9
Assen
9404 LA
Netherlands

Study information

Study designSingle-centre double blind cross-over study
Primary study designInterventional
Secondary study designRandomised cross over trial
Study setting(s)Other
Study typeTreatment
Participant information sheet No participant information sheet available
Scientific titleThe effect of 7.5 mg mirtazapine and 50 mg quetiapine, compared to placebo, on situational insomnia and daytime functioning in healthy male subjects
Study hypothesis7.5 mg mirtazapine or 50 mg quetiapine improve situational insomnia, without affecting daytime functioning.
Ethics approval(s)Regional ethics board METC Isala Zwolle, 03/03/2014, ref: 13.11138
ConditionInsomnia
InterventionParticipants attend the study centre on consecutive nights, for three consecutive weeks and receive the study treatments in a random order. The first night of the study is an adaption night and the study medication is taken 30 minutes before bed on the second and third night. During sleep, participants are monitored using polysomnography. Participants are interviewed 15 minutes and two hours after waking to assess sleep quality and daytime sleepiness.

Study treatments:
7.5 mg mirtazapine
50 mg quetiapine
Placebo
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)1. Mirtazapine 2. Quetiapine
Primary outcome measure1. Sleep quality is measured using polysomnography during each night
2. Subjective sleep is measured by the Leeds Sleep Evaluation Questionnaire (LSEQ) 15 minutes after waking
Secondary outcome measures1. Daytime sleepiness is measured by the Karolinska Sleepiness Scale (KSS) 2 hours after waking
2. Daytime cognitive functioning is measured by the Psychomotor Vigilance Task (PVT) and the Digit Symbol Substitution Task (DSST) 2 hours after waking
Overall study start date01/01/2014
Overall study end date02/09/2015

Eligibility

Participant type(s)Healthy volunteer
Age groupAdult
Lower age limit18 Years
Upper age limit35 Years
SexMale
Target number of participants19
Participant inclusion criteria1. Male
2. Aged between 18-35 years
3. BMI between 18.0-30 kg/m2
4. Absence of clinically relevant health problems
5. History of going to bed from 22.00h to 00.00h on at least 5-7 nights per week, with a reported sleep duration of 6.5-8.5h over the previous 3 months before the start of and during the study
Participant exclusion criteria1. History of sleep disorder or psychiatric illness
2. Family history of sleep disorder or psychiatric disorder
3. Liver disease
4. Cardiovascular disease
5. Alcohol or drug dependence
6. Use of (psychotropic) medication
7. Known intolerance for either mirtazapine or quetiapine
Recruitment start date01/09/2014
Recruitment end date01/05/2015

Locations

Countries of recruitment

  • Netherlands

Study participating centre

GGZ Drenthe
Dennenweg 9
Assen
9404 LA
Netherlands

Sponsor information

GGZ Drenthe
Hospital/treatment centre

Dennenweg 9
Assen
9404 LA
Netherlands

ROR logo "ROR" https://ror.org/0107rkg57

Funders

Funder type

Industry

GGZ Drenthe
Private sector organisation / Other non-profit organizations
Alternative name(s)
Geestelijke Gezondheidszorg Drenthe
Location
Netherlands

Results and Publications

Intention to publish date01/09/2016
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination plan1. Planned publication of study results in a peer reviewed journal
2. Planned dissemination of findings at national and international conferences
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/03/2017 29/01/2019 Yes No

Editorial Notes

29/01/2019: Publication reference added