McCall WV, et al. - Researchers examined the efficacy of providing targeted treatment of insomnia with controlled-release zolpidem (zolpidem-CR) vs placebo in reducing suicidal ideation among suicidal adults with insomnia. They conducted Reducing Suicidal Ideation Through Insomnia Treatment, an 8-week three-site double-blind placebo-controlled parallel-group randomized controlled trial randomly assigning a total of 103 participants to receive zolpidem-CR (N = 51) or placebo (N = 52), in conjunction with an open-label selective serotonin reuptake inhibitor; 64 women and 39 men; mean age = 40.5 years. They observed a robust anti-insomnia effect of zolpidem-CR, especially in patients with the most severe insomnia symptoms. The Scale for Suicide Ideation exhibited no significant treatment effect, but there was a significant positive correlation of reduction in scores with improvement in insomnia after accounting for the effect of other depression symptoms. These findings suggest a possible benefit of coprescription of a hypnotic during initiation of an antidepressant in suicidal outpatients, particularly in patients with severe insomnia, however, the routine prescription of hypnotic medication for decreasing suicidal ideation in all depressed outpatients with insomnia is not supported.