Antidepressants for insomnia in adults
Worth asking your prescriber how long you are expected to stay on trazodone for sleep, since the supporting trials were short-term and using it for insomnia is off-label.
Top of the evidence hierarchy, independently funded. how we score evidence
Caveat on this rating: Trazodone is the most commonly prescribed antidepressant for insomnia in the USA, but this use is off-label; the review found no evidence on long-term use and rated adverse-event evidence low certainty.
Pooling 3 trials with 370 participants, low-dose trazodone gave a moderate short-term improvement in how people rated their sleep versus placebo (SMD -0.34; moderate-certainty evidence), but 2 trials with sleep-lab measurement found little or no difference in actual sleep efficiency.
Worth asking
Worth asking your prescriber how long you are expected to stay on trazodone for sleep, since the supporting trials were short-term and using it for insomnia is off-label.
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Major depressive disorder
Source
Antidepressants for insomnia in adults — Everitt H, et al. (2018)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1002/14651858.CD010753.pub2
DOI: 10.1002/14651858.CD010753.pub2
How this was scored
- Study design
- Systematic review of randomised trials
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 370
- Preregistered
- Yes
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 95 out of 100 on our published rubric. One caveat travels with that badge: Trazodone is the most commonly prescribed antidepressant for insomnia in the USA, but this use is off-label; the review found no evidence on long-term use and rated adverse-event evidence low certainty. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Antidepressants for insomnia in adults — Everitt H, et al. (2018). Published in: Top-tier peer-reviewed journal. DOI: 10.1002/14651858.CD010753.pub2. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Systematic review of randomised trials. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is trazodone (Desyrel, Oleptro), desyrel, oleptro FDA approved?
Yes — FDA approved for Major depressive disorder. Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.