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AJP CME: November 2019 - Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT): A Randomized Clinical Trial

Activity Type:

  • Journal CME

Release Date: 11/1/2019

Expiration Date: 10/31/2021

  • AMA PRA Category 1: 1
  • Participation: 1



Objective: The authors sought to determine whether targeted treatment of insomnia with controlled-release zolpidem (zolpidem-CR) in suicidal adults with insomnia would provide a reduction in suicidal ideation superior to placebo.

Methods: Reducing Suicidal Ideation Through Insomnia Treatment was an 8-week three-site double-blind placebo-controlled parallel-group randomized controlled trial of zolpidem-CR hypnotic therapy compared with placebo, in conjunction with an open-label selective serotonin reuptake inhibitor. Participants were medication-free 18- to 65-year-olds with major depressive disorder, insomnia, and suicidal ideation. Suicidal ideation was the main outcome, measured first by the Scale for Suicide Ideation and second by the Columbia–Suicide Severity Rating Scale (C-SSRS).


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Educational Objective

The participant will appraise the value of adding hypnotic medication to selective serotonin reuptake inhibitor medication for the treatment of suicidal ideation in suicidal patients with insomnia.

Target Audience

This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.

Estimated Time to Complete

Duration: 1 hour
Begin Date: November 1, 2019
End Date: October 31, 2021

How to Earn Credit

In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™).  A score of 60% or higher is required to receive credit.


The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

Title: Reducing Suicidal Ideation Through Insomnia Treatment (REST-IT): A Randomized Clinical Trial

Authors: William V. McCall, M.D., Ruth M. Benca, M.D., Peter B. Rosenquist, M.D., Nagy A. Youssef, M.D., Laryssa McCloud, Ph.D., Jill C. Newman, M.S., Doug Case, Ph.D., Meredith E. Rumble, Ph.D., Steven T. Szabo, M.D., Ph.D., Marjorie Phillips, M.S., Andrew D. Krystal, M.D.

Affiliations: Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University (W.V.M.C., P.B.R., N.A.Y., L.M.C.), and the Pharmacy Department, Augusta University Health (M.P.), Augusta, Ga.; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine (R.M.B.); Department of Medicine, Medical University of South Carolina, Charleston (J.C.N.); Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C. (D.C.); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (M.E.R.); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. (S.T.S., A.D.K.); Durham VA Health Care System, Durham, N.C. (S.T.S.); Langley Porter Psychiatric Hospital and Clinics and Department of Psychiatry, University of California, San Francisco, San Francisco (A.D.K.).

Disclosures: Dr. McCall receives honoraria from Anthem, CME Outfitters, and Wolters Kluwer and research support from MECTA, Merck, and VistaGen; he is an adviser for Jazz and Sage. Dr. Benca is a consultant for Eisai, Genomind, Jazz, and Merck and receives grant support from Merck. Dr. Youssef has received research support from August Research, MECTA, Merck, and the VA. Dr. Rumble receives research support from Merck. Dr. Szabo receives grant support from Janssen, NIH, and Otsuka and is a consultant to Jazz, Neurocrine, Otsuka, and Teva. Dr. Krystal receives grant support from Axsome, Janssen, Jazz, NIH, and Reveal Biosensors and is a consultant to Adare, Eisai, Ferring, Galderma, Idorsia, Janssen, Jazz, Merck, Neurocrine, Pernix, Physician’s Seal, and Takeda. The other authors report no financial relationships with commercial interests.

Discussion of unapproved or investigational use of products*: No.

*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.

Program Planners

Ned H. Kalin, M.D. (Editor-in-Chief, AJP); Carolyn Rodriguez, M.D., Ph.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals). Dr. Kalin has served as a consultant to the Board of Scientific Advisors, the Pritzker Neuropsychiatric Disorders Research Consortium, and the Skyland Trail Advisory Board and as Councilor, Society of Biological Psychiatry. Dr. Rodriguez has served as a consultant to Allergan, Blackthorn, Epiodyne, and Rugen. Mr. Roy and Mr. Pogachar report no financial relationships with commercial interests.

Hardware/Software Requirements

This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.
Optimal System Configuration:
  • Flash Player: Adobe Flash Player 10.1+ 
  • Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+ 
  • Operating System: Windows XP+ or Mac OS X 10.4+ 
  • Internet Connection: 1 Mbps or higher
  • Screen Resolution: 1024 x 768 pixels.

Minimum Requirements:

  • Windows PC:500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
  • Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit

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