{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T16:26:21Z","timestamp":1772900781393,"version":"3.50.1"},"reference-count":21,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"5","license":[{"start":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T00:00:00Z","timestamp":1409529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can Pharm J"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Insomnia is one of the most frequent complaints encountered in primary care practice, one that results in significant clinical consequences and cost burden to the public health system. It is more common in elderly adults (\u226565 years of age), with frequent complaints regarding sleep maintenance and early morning wakening. Current treatment options have limitations. This review was conducted to evaluate the evidence behind ultra-low-dose doxepin in insomnia and to discuss its potential advantages, its place in therapy and its implications in practice in the treatment of older patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic literature search was conducted of MEDLINE via Ovid, PubMed and EMBASE using the MeSH and key terms \u201cdoxepin,\u201d \u201csleep initiation and maintenance disorders,\u201d \u201cinsomnia,\u201d and \u201clow dose.\u201d Only randomized controlled trials comparing 3 mg and\/or 6 mg of doxepin to placebo and involving participants diagnosed with primary insomnia were included. Primary outcomes for this review were objective sleep study parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five studies were identified, 3 of which ( n = 571) were conducted in older adults. Doxepin 3 mg and 6 mg significantly reduced waking after sleep onset and increased total sleep time. There was no significant difference between the 2 doses of doxepin. Latency to persistent sleep did not differ significantly compared with placebo for any doses of doxepin. The most frequent adverse events reported were somnolence and headache. Adverse events did not appear to be dose-related, and studies reported the incidence of adverse effects to be comparable to placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Doxepin 3 mg and 6 mg significantly improved and sustained sleep maintenance and sleep duration into the last third of the night but did not significantly affect sleep onset. Sleep benefits were achieved without next-day residual or discontinuation effects. Doxepin appears to be well suited for managing insomnia in older people.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1715163514543856","type":"journal-article","created":{"date-parts":[[2014,9,23]],"date-time":"2014-09-23T00:20:58Z","timestamp":1411431658000},"page":"281-289","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["Use of ultra-low-dose (\u22646 mg) doxepin for treatment of insomnia in older people"],"prefix":"10.3138","volume":"147","author":[{"given":"Carlos H.","family":"Rojas-Fernandez","sequence":"first","affiliation":[{"name":"Schlegel-UW Research Institute for Aging (Rojas-Fernandez), University of Waterloo, Waterloo"},{"name":"School of Pharmacy (Rojas-Fernandez, Chen), University of Waterloo, Waterloo"},{"name":"School of Public Health and Health Systems (Rojas-Fernandez), Faculty of Applied Health Sciences, University of Waterloo"},{"name":"Michael G. DeGroote School of Medicine (Rojas-Fernandez), Dept. of Family Medicine, McMaster University, Hamilton, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannan","family":"Chen","sequence":"additional","affiliation":[{"name":"Schlegel-UW Research Institute for Aging (Rojas-Fernandez), University of Waterloo, Waterloo"},{"name":"School of Pharmacy (Rojas-Fernandez, Chen), University of Waterloo, Waterloo"},{"name":"School of Public Health and Health Systems (Rojas-Fernandez), Faculty of Applied Health Sciences, University of Waterloo"},{"name":"Michael G. DeGroote School of Medicine (Rojas-Fernandez), Dept. of Family Medicine, McMaster University, Hamilton, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1696","published-online":{"date-parts":[[2014,9,22]]},"reference":[{"key":"bibr1-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"bibr2-1715163514543856","volume-title":"Sleep disorders","author":"Hirshkowitz M","year":"2009","edition":"9"},{"key":"bibr3-1715163514543856","first-page":"9","volume":"17","author":"Tjepkema M","year":"2005","journal-title":"Health Rep"},{"key":"bibr4-1715163514543856","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1093\/sleep\/32.12.1649","volume":"32","author":"Daley M","year":"2009","journal-title":"Sleep"},{"key":"bibr5-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.11.1553"},{"key":"bibr6-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2011.09.006"},{"key":"bibr7-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1177\/0269881110379307"},{"key":"bibr8-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2010.08.006"},{"key":"bibr9-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1592\/phco.27.1.89"},{"key":"bibr10-1715163514543856","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n1005"},{"key":"bibr11-1715163514543856","first-page":"1","volume":"2011","author":"Swick TJ","journal-title":"Sleep Med Clin"},{"key":"bibr12-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1517\/14656560903005587"},{"key":"bibr13-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/30.11.1555"},{"key":"bibr14-1715163514543856","first-page":"1433","volume":"34","author":"Krystal AD","year":"2011","journal-title":"Sleep"},{"key":"bibr15-1715163514543856","unstructured":"Paladin Pharmaceuticals Inc. Silenor (doxepin) tablets for oral administration: Canadian prescribing information. Available: www.paladin-labs.com\/our_products\/PM_Silenor_EN.pdf (accessed Oct. 25, 2013)."},{"key":"bibr16-1715163514543856","unstructured":"Paladin Labs announces Canadian approval for Silenor. Marketwire 2012 December 17. Available: http:\/\/paladin-labs.mwnewsroom.com\/press-releases\/paladin-labs-announces-canadian-approval-for-silen-tsx-plb-201212170842340001 (accessed May 18, 2013)."},{"key":"bibr17-1715163514543856","unstructured":"Wilson DB. Practical meta-analysis effect size calculator. The Campbell Collaboration. Available: www.campbellcollaboration.org\/escalc\/html\/EffectSizeCalculator-SMD1.php (accessed Sept. 22, 2013)."},{"key":"bibr18-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852900017089"},{"key":"bibr19-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e8343"},{"key":"bibr20-1715163514543856","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550240060035"},{"key":"bibr21-1715163514543856","doi-asserted-by":"publisher","DOI":"10.2165\/11200810-000000000-00000"}],"container-title":["Canadian Pharmacists Journal \/ Revue des Pharmaciens du Canada"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1715163514543856","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1715163514543856","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1715163514543856","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T22:05:32Z","timestamp":1772834732000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1715163514543856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1177\/1715163514543856"],"URL":"https:\/\/doi.org\/10.1177\/1715163514543856","relation":{},"ISSN":["1715-1635","1913-701X"],"issn-type":[{"value":"1715-1635","type":"print"},{"value":"1913-701X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9]]}}}