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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Kinetics and mechanism of action of benzodiazepines are at the base of their proper use in clinical management of anxiety, tension, panics, and insomnia. These important agents have specific receptors within the complex GABA-ergic system: according to the most recent studies, GABAA receptors are more important than GABAB receptors. The author illustrates the management of anxiety states, as well as the treatment of anxiety in children, in old people and of panic attacks. Since the use of benzodiazepines has become excessive, the risk of dependence is discussed as well as possible alternatives (buspirone, antidepressants). Finally, the usefulness of anxiolytic drug treatment is stressed which is one of the pivots of psychopharmacology and the study of the GABA-ergic system.
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PMID:[The mechanism of action of benzodiazepine and its consequences for therapy]. 135 Feb 39

Sleep disorders related to depressive illness are now well documented. However, sleep disturbances associated with anxiety have only been explored in recent time. All types of anxiety (generalized anxiety, obsessive-compulsive disorders, panic attack) are associated with sleep disorders such as early insomnia, sleep interruption and low efficiency of sleep. The EEG approach gives different results according to the type of anxiety. Generalized anxiety is associated with total sleep time reduction and low efficiency of sleep. Sleep is unstable with numerous awakenings. Longer periods of stage 1 and 2 sleep are observed and slow wave sleeps as well as REM sleep time is reduced. REM sleep latency may be reduced in obsessive compulsive disorders. Although sleep abnormalities observed in anxiety disorders differ from those observed in depressive disorders, none of these features can be considered specific of anxiety.
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PMID:[Sleep disorders related to anxiety]. 198 13

The authors studied 954 psychiatric patients with major affective disorders and found that nine clinical features were associated with suicide. Six of these--panic attacks, severe psychic anxiety, diminished concentration, global insomnia, moderate alcohol abuse, and severe loss of interest or pleasure (anhedonia)--were associated with suicide within 1 year, and three others--severe hopelessness, suicidal ideation, and history of previous suicide attempts--were associated with suicide occurring after 1 year. These findings draw attention to the importance of 1) standardized prospective data for studies of suicide, 2) assessment of short-term suicide risk factors, and 3) anxiety symptoms as modifiable suicide risk factors within a clinically relevant period.
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PMID:Time-related predictors of suicide in major affective disorder. 185 69

A single-subject research design was employed to assess the efficacy of rational self-directed hypnotherapy in the treatment of panic attacks. Presenting symptoms were acute fear, dizziness, constricted throat, upset stomach, loss of appetite, loss of weight, insomnia, fear of doctors, and fear of returning to work. Treatment lasted 13 weeks plus a 2-week baseline and posttherapy period and a 6-month follow-up. Objective measurements (MMPI, TSCS, POMS) and self-report assessments (physiological symptoms and a subjective stress inventory) were implemented. Using hypnosis and guided imagery, the subject reviewed critical incidents identifying self-defeating components within a cognitive paradigm, revising and rehearsing these incidents. Results showed an increased sense of control, improved self-concept, elimination of pathological symptoms, and cessation of panic attacks.
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PMID:Rational self-directed hypnotherapy: a treatment for panic attacks. 229 17

Patients with alcohol dependence commonly experience symptoms of anxiety, depression, and insomnia. It is essential that clinicians recognize and treat anxiety disorders in alcoholic patients. Panic attacks with and without agoraphobia are especially prevalent among alcoholics and their families. Treatments of choice for panic disorder are the monoamine oxidase inhibitors, as well as tricyclic antidepressants and the benzodiazepine alprazolam. Benzodiazepines seem to be effective in controlling two pathophysiologic characteristics of alcohol withdrawal--noradrenergic and hypothalamic-pituitary-adrenocortical overactivity. They also can be used to prevent and treat withdrawal seizures and delirium tremens. They are not indicated for the treatment of alcohol dependence per se.
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PMID:Anxiety and alcoholism. 268 Nov 71

Forty-five panic disorder patients and 26 normal control subjects were surveyed regarding their histories of sleep panic attacks, insomnia, and vulnerability to exogenous panic stimuli. Sixty-nine percent (N = 31) of the patients reported having experienced sleep panic at some time in their lives, and 33% (N = 15) of the patients experienced recurrent sleep panic. The implications of these findings for the management of panic disorder are discussed.
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PMID:Sleep panic attacks: new clinical findings and theoretical implications. 211 49

The Stress Clinic has been established for the systematic investigation and quantification of various stress factors that may produce adverse effects on health. Nine areas are investigated: social habits, social relationships, life events, psychiatric, sexual, sleep, geriatric, menstrual, and stress and the heart. The degree of stress in each area is quantified and a Stress Profile constructed for each patient. The Stress Profile can then be used to determine in which areas stress is most important and appropriate treatment can then be prescribed. In a preliminary analysis, the commonest principal diagnosis was depression (47%), followed by anxiety (27%), whilst in 18% the main stress was insomnia and in three patients an organic illness (7%). The Stress Profile is also used to assess improvement and significant reduction in many of the main stress areas has been demonstrated, coincident with response to treatment. In particular, we have been using centrally acting beta-blocking drugs in the treatment of anxiety and panic attacks with similar results.
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PMID:Experiences of a stress clinic. 290 96

The jitteriness syndrome (jitteriness, shakiness, increased anxiety, and insomnia) can develop with low doses of tricyclic antidepressants in patients who are sensitive to these drugs. The authors review the antidepressant treatment of 180 patients. Only those with panic attacks had jitteriness, usually during the first week of treatment. Desipramine was associated with a much higher frequency of jitteriness than was imipramine. Tolerance to jitteriness occurred with continued treatment, but fewer patients with jitteriness responded to treatment, apparently because of difficulties in increasing the dose. Characteristics of the jitteriness syndrome in panic disorder patients are consistent with noradrenergic hypotheses of panic anxiety. The clinical and theoretical implications of these findings are discussed.
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PMID:The jitteriness syndrome in panic disorder patients treated with antidepressants. 291 84

The spectrum ranges from fearful concerns about illness to clinical anxiety disorders, such as phobias, panic attacks, generalized anxiety, post-traumatic stress disorder and adjustment disorder. Anxiety and fear are often associated with hospitalization, heart disease, insomnia, and somatopsychic syndromes. Determining the cause of the anxiety may help the physician plan the treatment approach. In selected cases, benzodiazepines are useful adjuncts to therapy.
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PMID:The spectrum of anxiety disorders in family practice. 368 77

Some patients with panic attacks are extremely sensitive to tricyclic antidepressants and develop jitteriness, shakiness, and insomnia when given very low doses. Two patients who developed this "jitteriness syndrome" while taking tricyclic antidepressants are described. The side effects in these patients were markedly relieved by the addition of perphenazine.
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PMID:Response of tricyclic-induced jitteriness to a phenothiazine in two patients. 373 76


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