Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The dependency potential of chlormethiazole has been assessed on the basis of animal studies (rat and monkey) and an extensive analysis of human cases reported in the international clinical literature covering a period of 17 years. The results of the animal studies do not show any major physical or psychological dependence on chlormethiazole. Clinical studies of case reports suggest that the evidence for "primary" dependence on chlormethiazole is weak, as most of the analysable cases had a previous history of alcohol and/or other drug abuse/dependence. Moreover, in a high proportion of these cases there was evidence of simultaneous alcohol and/or other drug abuse. It should be stressed that in this group of patients the dependence on chlormethiazole was invariably reported in connection with long-term out-patient medication, that is, in a way that was not in accordance with recommendations for use of the drug in "dried out" alcoholics and/or drug addicts. Reports of chlormethiazole abuse/dependence from the alcohol/drug addiction indication are may involve a population particularly prone to addiction and, therefore, be unrepresentative for general assessment. Conversely, the findings in animal studies provide indirect support for the favourable clinical experiences with chlormethiazole in the geriatric, psychogeriatric and obstetric indication areas where chlormethiazole has been used extensively for more then a decade in a problem-free manner. The risk which applies to long-term use in alcoholics and/or drug addicts or the emotionally unstable, because of their "dependency proneness", does not seem to apply to the treatment of conditions, such as insomnia and agitation, in the elderly in whom the drug has been found to be very useful by various investigators.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Experimental studies and clinical experiences on the dependency potential of chlormethiazole. 309 87

Alcohol and drug addiction are defined in behavioral terms as the preoccupation with, compulsive use of, and relapse to drugs that are descriptive and confirmatory. The basis of addiction may involve neurochemical changes in the brain that distort and redirect the drive states (instincts). Tolerance and dependence may only be incidentally associated with addiction as a result of a nonspecific adaptation by the body to the presence of a drug. The cellular adaptation may be the same in all organs. Addiction to alcohol and drugs may have no specific relationship to tolerance and dependence. Addiction occurs in the absence of observable tolerance and dependence to alcohol and drugs. Alcohol and drug addiction is probably more complex than tolerance and dependence. Addiction is difficult to study because of the variability of behavioral phenomena and the underlying intricacies of the neurosubstrates. Tolerance and dependence are still useful as they are indicators of drug use. It is a misconception that long term chronic use is necessary for tolerance and dependence to develop. Some studies have shown that tolerance can develop within hours and days to a single dose of alcohol or other drugs. Anxiety, depression and insomnia can occur after a single dose of ethanol in humans. These symptoms of withdrawal from the alcohol or drug constitute dependence. Redefining the criteria for addiction tolerance and dependence to alcohol and other drugs may be in order. A neurochemical model may provide a more definitive and uniform basis for considering addiction, tolerance, and dependence to alcohol and drugs.
 ...
PMID:The relationship of addiction, tolerance, and dependence to alcohol and drugs: a neurochemical approach. 332 55

The propriety of narcotic usage at the Hadassah Hospital has been studied in 35 cancer patients and 70 post-operative patients. Eighty-three per cent of the cancer patients and 66% of the surgical patients remained in moderate to severe distress in spite of the analgesic therapy. Insomnia and anxiety, plus depression in the cancer patients, were the major results of uncontrolled pain. The inadequacy of the treatment was attributed to the incorrect selection of medication, usage "as needed' policy and smaller daily doses than advocated. This resulted mainly because of exaggeration of the risk of tolerance and addiction by both patients and personnel.
 ...
PMID:The propriety of narcotic usage in hospitalized patients. 395 14

The capacity of the benzodiazepine drugs to produce dependence and addiction has been associated with what has recently been recognized as a benzodiazepine withdrawal syndrome. Abrupt discontinuation of benzodiazepine treatment may show a spectrum of symptoms similar to those observed from withdrawal of alcohol or barbiturates. Such reactions have been reported with and are reviewed for the following drugs: chlordiazepoxide, diazepam, oxazepam, lorazepam, nitrazepam, temazepam, and clobazam. Generally, the higher the dose and the longer the benzodiazepine is taken, the greater the risk of developing withdrawal symptoms. However, withdrawal symptoms may occur in patients receiving recommended doses and/or short-term therapy. Although most withdrawal reactions have been reported with the long-acting benzodiazepines having psychoactive metabolites, reactions may also occur with the short-acting agents. In contrast, rebound insomnia occurs with greater frequency and severity with the short-acting agents. Benzodiazepine therapy should be stopped as early as possible, with tapering after moderate dose and/or prolonged use therapy.
 ...
PMID:Benzodiazepine withdrawal syndrome: a literature review and evaluation. 613 46

We relate two cases of amineptine (Survector) overconsumption by patients cured for atypical depression with asthenia and activities deficit as the prevalent symptoms. Prescription of two tablets a day (0,200 g) was respected in one case during six months, and in the other case during two years, with therapeutic benefit on apragmatism. To no obvious reason, within few months both patients had gradually raised the doses to twenty tablets (2 g) and thirty tablets (3 g) respectively: we observed subexcitation, insomnia, sensorial hyperaesthesia, irritability, tachyphemia with dysarthria, anorexia with weight lost of more than 10 kg and amphetamine-like troubles without confusion or delusion, as a result of which both patients were treated for their addiction, in hospital. Treatment with clorazepate perfusions did not cause any physical dependence problems. However, psychological dependence was strong enough for one of the patients to go out, on the third day, against medical decision. As far as we know, in France, only one such case of addiction use at high doses and in single intakes is mentioned in the existing literature. However, our observations suggest that it might be necessary to re-assess the place of amineptine among new antidepressive molecules with psychostimulant abilities.
 ...
PMID:[2 cases of amineptine dependence]. 614 28

Despite the vast literature on drug dependence, little has been written about patients who become addicted while taking medically prescribed drugs for organic pathology. Observations from a psychiatric consultation-liaison service reveal that these patients are frequently middle-aged with no history of drug abuse before the onset of a chronic medical condition. Associated with their medical condition is a dependence on narcotics and/or psychotropic medications for such complaints as pain, headache, insomnia, and anxiety. Thea addiction may persist for years without acknowledgement by a patient, doctor, or family, although there is usually a progressive constriction of social and occupational functioning. The primary physician is highly valued by the patient; this manifest appreciation trends to facilitate the primary physician's continued prescription of large doses of addicting drugs. Treatment involving detoxification typically goes through a series of stages, each of which has characteristic hazards and pitfalls that can lead to failure of treatment.
 ...
PMID:Treatment of iatrogenic drug dependence in the general hospital. 746 45

According to the hypothesis implying that the main mechanism underlying opiate addiction is the blockade by opiates of NMDA receptor functions and subsequent upregulation and supersensitivity of the receptors, noncompetitive NMDA receptor blocker dextromethorphan (DM) has been successfully used in the heroin addict treatment. As the stimulation of NMDA receptors modulates the release of neurotransmitters and hormones such as NE, D, ACh, GH, LH, LSH, ACTH etc., all of which have been found responsible for the manifestation of abstinence syndrome signs including craving and neuronal death by excessive stimulation of NMDA receptors, the incomplete blockade of the NMDA receptors minimizes the intensity of the abstinence syndrome and provides the downregulation of the receptors. In the present study, tizanidine (TIZ), which inhibits the release of endogenous excitatory aminoacids by the agonistic activity on alpha 2-adrenoreceptors, was combined with DM to obtain further benefits. Forty-four male and three female heroin addicts were the subjects of the study. Their daily mean heroin intake was about 2.28 g street heroin. The main duration of heroin use was approximately 3.4 years. Two to three hours after abrupt withdrawal, the outpatients were given 15 mg DM every hour, 25 or 50 mg chlorpromazine (CPZ) + 4 mg TIZ every six hours and 10 mg diazepam + 10 mg hyoscine N-butyl Br + 250 mg dipyrone every six hours three hours following CPZ. The addicts were controlled twice a day. Yawning, rhinorrhea, perspiration, piloerection, restlessness, insomnia, emesis, diarrhea, craving, rejection of smoking and pupils were observed and/or questioned. Two of the 47 outpatients took heroin on the first days.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The combination of tizanidine markedly improves the treatment with dextromethorphan of heroin addicted outpatients. 771 85

Dextromethorphan (DM), the dextrorotatory isomer of 3-hydroxy-N-methylmorphinan, is the main ingredient in a number of widely available, over-the-counter antitussives. Initial studies (Bornstein 1968) showed that it possessed no respiratory suppressant effects and no addiction liability. Subsequently, however, several articles reporting abuse of this drug have appeared in the literature. The drug is known to cause a variety of acute toxic effects, ranging from nausea, restlessness, insomnia, ataxia, slurred speech and nystagmus to mood changes, perceptual alterations, inattention, disorientation and aggressive behavior (Rammer et al 1988; Katona and Watson 1986; Isbell and Fraser 1953; Devlin et al 1985; McCarthy 1971; Dodds and Revai 1967; Degkwitz 1964; Hildebrand et al 1989). There have also been two reported fatalities from DM overdoses (Fleming 1986). However, there are no reports describing the effects of chronic abuse. This report describes a case of cognitive deterioration resulting from prolonged use of DM.
 ...
PMID:Cognitive deterioration from long-term abuse of dextromethorphan: a case report. 780 71

The indications for the benzodiazepines include anxiety, insomnia, muscle spasm and epilepsy and each disorder has a variety of biological substrates. Limbic structures and the neurotransmitters noradrenaline, 5-HT and GABA have all been implicated. Benzodiazepines act on allosteric receptor sites and potentiate the actions of GABA in modulating chloride ionophores across nerve membranes. These effects can be blocked by the benzodiazepine antagonist, flumazenil. The molecular pharmacology of the benzodiazepine-GABA-chloride receptor is complex, with a wide range of different subunits. Animal models of dependence have suggested that the changes associated with long-term benzodiazepine use are related more to receptor-effector coupling than to the receptor characteristics themselves. Thus, benzodiazepine agonists on long-term use lose their efficacy, antagonists become partial inverse antagonists, and inverse agonists increase in efficacy. Various clinical implications are explored, including the use of flumazenil to prevent and to treat benzodiazepine withdrawal syndromes.
Addiction 1994 Nov
PMID:Biological processes in benzodiazepine dependence. 784 50

Physiological dependence on benzodiazepines is accompanied by a withdrawal syndrome which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes. Instances are also reported within the high-dosage category of more serious developments such as seizures and psychotic reactions. Withdrawal from normal dosage benzodiazepine treatment can result in a number of symptomatic patterns. The most common is a short-lived "rebound" anxiety and insomnia, coming on within 1-4 days of discontinuation, depending on the half-life of the particular drug. The second pattern is the full-blown withdrawal syndrome, usually lasting 10-14 days; finally, a third pattern may represent the return of anxiety symptoms which then persist until some form of treatment is instituted. Physiological dependence on benzodiazepines can occur following prolonged treatment with therapeutic doses, but it is not clear what proportion of patients are likely to experience a withdrawal syndrome. It is also unknown to what extent the risk of physiological dependence is dependent upon a minimum duration of exposure or dosage of these drugs. Withdrawal phenomena appear to be more severe following withdrawal from high doses or short-acting benzodiazepines. Dependence on alcohol or other sedatives may increase the risk of benzodiazepine dependence, but it has proved difficult to demonstrate unequivocally differences in the relative abuse potential of individual benzodiazepines.
Addiction 1994 Nov
PMID:The benzodiazepine withdrawal syndrome. 784 56


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>