Doxepin Alone or Combined With Ramelteon Versus Placebo for Improving Sleep Quality After Primary Total Knee Arthroplasty

Starting soon · Phase 4 · Has a placebo group

Conditions studied: Sleep Quality Post-TKA, Postoperative Knee Function, Quality of Life After Primary TKA

In brief

Many patients experience poor sleep during recovery after total knee arthroplasty (TKA). Disturbed sleep can last weeks to months and may worsen pain, slow healing, and reduce overall quality of life. Few safe, effective, evidence-based options exist to improve sleep during this recovery period. This study aims to determine whether the medications doxepin, either alone or in combination with ramelteon, can improve sleep quality during early recovery after TKA. The investigators will also evaluate whether improved sleep leads to better pain control, knee function, and overall quality of life.

Key facts

Study ID

NCT07598734

Run by

University of Washington

People needed

129

Starts

2026-06-01

Expected to finish

2028-06-01

Last updated by the study team

2026-05-20

Who can join

Age: 18 and older, up to 80. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Those receiving primary total knee arthroplasty (TKA)
• 80 years or less, age 18 or greater

You may not qualify if…

• History of cardiovascular bundle branch block
• Actively taking selecrtive serotoin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), or having treatment via counseling/psychotherapy for major depression or anxiety, bipolar, or psychotic disorder
• Pre-operative narcotics (defined as more than 1 prescription in the past 3 months)
• Self-reported use of alcohol in excess of >2 drinks/day (in men) and > 1 drink/day (in women)
• Use of prescription sleep aids (e.g., Ambien, Trazadone) prior to surgery (i.e., melatonin or other OTC sleep aids are permitted)
• History of major sleep disorder (e.g., obstructive sleep apnea (OSA), restless leg syndrome, narcolepsy)
• Pregnant, breastfeeding or planning to become pregnant in the next 3 months post-surgery. No pregnancy testing will be performed; screening will rely solely on participant self-report.
• Unable to take the study medication(s) due to contraindications with other medications the patient uses
• Have been diagnosed with (or are at risk of) narrow-angle or angle-closure glaucoma. In order to be eligible, participants must be able to report that they have had their eyes dilated within the past year without problems.
• Have severe urinary retention or difficulty emptying your bladder.
• Had glaucoma-related eye procedures (e.g., laser iridotomy)
• Ongoing use of glaucoma eye drops.

Where it is running

• University of Washington Medical Center Hip & Knee Center — Seattle, Washington, United States

Full record on ClinicalTrials.gov

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