Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Quazepam is a trifluoroethyl benzodiazepine hypnotic with a half-life of 27 to 41 hours, which has been shown to induce and maintain sleep in the short to long term (up to 4 weeks) treatment of patients with chronic or transient insomnia. Although its hypnotic efficacy has been well characterised against placebo, there are few clinical studies in comparison with established hypnotics, particularly over long term administration. However, preliminary evidence suggests that quazepam 15 to 30 mg is as effective as flurazepam and triazolam in usual therapeutic doses, and causes minimal rebound insomnia following its withdrawal, unlike rapidly eliminated benzodiazepines such as triazolam. The lack of rebound phenomena is likely to be attributable to the 'carryover' effects occurring after discontinuation of quazepam, which has pharmacologically active metabolites with half-lives of elimination similar to or longer than that of the parent drug. Probably because of the long half-lives of quazepam's metabolites, daytime sedation, fatigue and lethargy are the most frequently reported side effects. These side effects are most intense with the 30 mg dose and least with the 7.5mg dose, which has not been studied extensively. Hence, quazepam is an effective hypnotic which may be particularly suitable for short or medium term use in patients in whom withdrawal effects or rebound insomnia may be especially bothersome. Further definition of certain characteristics of its profile--such as its long term use and potential for development of tolerance or dependence, effects on psychomotor skills, efficacy of the 7.5mg dose, and suitability in elderly patients and patients with chronic organic diseases--will assist in more clearly defining its ultimate place in therapy.
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PMID:Quazepam. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in insomnia. 289 93

The safety and hypnotic efficacy of quazepam 30 mg vs placebo in 57 insomniac outpatients were assessed in a randomized, controlled comparison. Patients received placebo during a 3-night, single-blind baseline period, and then quazepam 30 mg or placebo during a 5-night, double-blind treatment period. Quazepam-treated patients reported significantly better sleep quantity and quality on the first treatment night and for the overall treatment period than did placebo patients. No clinically significant change was seen in pre- and posttreatment physical examinations, electrocardiograms, or routine laboratory tests. Of the 57 subjects, 20 (16 quazepam, 4 placebo) reported adverse experiences. All 20 reported daytime somnolence (drowsiness, lethargy, or sleepiness), and one quazepam-treated patient also had hypokinesia. Overall, quazepam 30 mg was a safe and effective hypnotic, with significant hypnotic activity on the first night of administration.
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PMID:Quazepam in the short-term treatment of insomnia in outpatients. 636 Oct 6