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

Sleep and memory were investigated in a well educated patient suffering from striato-nigral degeneration. Despite almost total insomnia (only 591 min of stages 1 and 2, without any stage 3, 4 or paradoxical sleep during a continuous 4 day recording) it was not possible to objectify significant short or long term memory impairment.
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PMID:[Insomnia and memory. Apropos of a case of striato-nigral degeneration]. 8 54

This study suggests that patients receiving daily doses of 40 mg of prednisone or its equivalent, are at greater risk for developing steroid psychosis. Psychotic reactions were twice as likely to occur during the first 5 days of treatment as subsequently. Premorbid personality, history of previous psychiatric disorder, and a history of previous steroid psychosis did not clearly increase the patient's risk of developing psychotic reaction during any given course of therapy. Steroid psychoses present as spectrum psychoses with symptoms ranging from affective through schizophreniform to those of an organic brain syndrome. No characteristic stable presentation was observed in these 14 cases reported here. The most prominent symptom constellation to appear some time during the course of the illness consisted of emotional lability, anxiety, distractibility, pressured speech, sensory flooding, insomnia, depression, perplexity, agitation, auditory and visual hallucinations, intermittent memory impairment, mutism, disturbances of body image, delusions, apathy, and hypomania. Phenothiazines administered in average daily doses of 212 mg produced excellent response in all patients studied. Of particular note was the fact that tricyclic antidepressants produced an exacerbation or worsening of the clinical state in all patients to whom they were administered.
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PMID:Presentation of the steroid psychoses. 43 94

Rationalisation of the war of hypnotics has recently been under discussion in France: a review of the benefits and risks of these substances may therefore be useful. Chronic insomnia is a result of multiple factors, among which individual characteristics of the personality play an important role. Hypnotic treatment is symptomatic; its beneficial influence on sleep progressively vanishes in few weeks, while some negative residual effects on daytime functioning (mood, alertness, performance, memory impairment) may persist. The main problems posed by hypnotic treatment with benzodiazepines are related to tolerance effects during the treatment period and to rebound insomnia and withdrawal phenomena after discontinuation. Practical issues for the treatment of insomnia, based on international consensus, are presented.
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PMID:[Benefits and risks of hypnotics]. 179 92

Three studies were conducted on elderly patients with dementia. A case of control study on life styles before falling ill revealed that "intake of sweets" was significantly associated with clinically diagnosed dementia of the Alzheimer's type. Evaluation of treatments of outpatients suggests that proper care and some kinds of neuroleptics are useful for alleviation of abnormal behavior such as agitation, wandering, hallucination, insomnia and depression, but not for improvement of cognitive function and memory. A study on caregivers of elderly demented patients was undertaken to determine the relationship between the components of burden and symptoms of patients. Insomnia and abnormal behavior of patients correlated with physical and mental components of the burden of caregivers. Memory disturbance, psychological symptoms and deterioration in ADL correlated with physical burden. These studies indicate that symptoms accompanying dementia such as insomnia, wandering, hallucination and agitation should be the treated intensively for the purpose of improvement of the quality of the lives of patients and caregivers.
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PMID:[Prevention and treatment of dementia: what should we do today?]. 194 24

Triazolam was administered to five psychiatric inpatients for a two-week period. This period was preceded by a one-week placebo baseline and followed by another week of placebo administration. All conditions were double blind. By the second week of active drug administration, psychopathology greatly intensified across all of the patients with the emergence of anxiety, memory impairment, confusion, paranoid ideation, and hallucinations. The drug-induced behavioral changes persisted during the initial withdrawal period, but then gradually subsided. Also following drug withdrawal, four patients showed a marked worsening of their sleeplessness for several nights.
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PMID:Behavioral side effects of triazolam in psychiatric inpatients: report of five cases. 351 16

Lorazepam, an anxiolytic drug, was evaluated in a 2-mg dose using a 16-night protocol including 7 nights of drug trial. Initially and with continued use the drug was moderately effective in inducing and maintaining sleep. Side effects included episodes of memory impairment and confusion in 2 subjects and group mean increases in daytime anxiety and tension with continued drug use. Following drug withdrawal, there was a marked and significant worsening of sleep above baseline levels (rebound insomnia) on the third night as well as significant increases in tension and anxiety the next day. The peak degree of withdrawal sleep disturbance was several times the peak degree of sleep improvement with drug administration.
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PMID:Lorazepam: effects on sleep and withdrawal phenomena. 396 Sep 63

Flurazepam, temazepam, and triazolam are compared in terms of initial and short term efficacy, effectiveness during intermediate and long term use, withdrawal effects, and general side effects. The usefulness of temazepam is considerably restricted since the drug is slowly absorbed; peak blood concentrations are not reached until 2 to 3 hours after ingestion. Consequently, while the majority of insomniac patients complain primarily of difficulty falling asleep, temazepam is not effective for this sleep complaint. Further, the drug has an intermediate elimination half-life and induces a significant degree of morning sleepiness (hang-over). Rebound insomnia of a moderate degree occurs with some frequency following withdrawal of temazepam. Triazolam is effective initially and with short term use both for inducing and maintaining sleep. However, much of this effectiveness is lost with continued nightly use over an intermediate period (2 weeks). The drug has a rapid elimination rate; during drug administration, sleep may worsen in the final hours of the night (early morning insomnia), and following drug withdrawal, rebound insomnia is frequent, immediate, and severe. Side effects are frequent and include some morning sleepiness (before tolerance develops) and significant memory impairment and even episodes of amnesia. Triazolam may have a narrow margin of safety in that serious behavioral symptoms have been reported even with a 1-mg dose. Flurazepam is effective both for initiating and maintaining sleep with initial and short term drug administration. Further, its efficacy is maintained not only with intermediate term use but with long term drug use (4 weeks). Flurazepam is a long elimination half-life drug, and there is significant daytime sedation during short term use; with continued use this effect diminishes. Rebound insomnia has not been noted following withdrawal of flurazepam; there is a carry-over effectiveness into the first and second nights of withdrawal, and any withdrawal sleep disturbance would be expected to be infrequent, delayed in appearance, and mild in degree.
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PMID:Sleep laboratory studies of hypnotic drugs: efficacy and withdrawal effects. 613 33

A wide range of neuropsychiatric side effects are attributed to propranolol including visual hallucinations, somnulence, memory impairment, decrease in response time, dizziness, confusional states, insomnia, nightmares, fatigue, sedation and depression. Benson et al., in a summary review of several clinical studies of 5,846 patients being treated with a variety of beta adrenergic blocking agents, listed depression as a rare side effect of propranolol that was usually reported only after long term treatment at high doses. Despite the widely circulated attribution that depression is a side effect of propranolol, there is a paucity of evidence to directly link this drug with clinically significant mood disturbance. For example, the most widely quoted reference attributing propranolol as a depressogenic agent was a "letter to the editor" which was a retrospective, uncontrolled, unblinded study that did not use a standardized depression rating scale. Most of the evidence linking propranolol to depressive symptoms have derived from scattered case reports in which the onset of depressive symptoms were attributed to this agent. Given the well known cyclic onset and remissions of affective disorders, and the prevalence of depression in the general medical population as a whole, the role of propranolol in these cases is debatable.
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PMID:Propranolol and depression: a reevaluation based on a pilot clinical trial. 640 May 97

Ten patients who were prescribed daily doses of diazepam for the treatment of anxiety, insomnia, or psychosomatic symptoms were assessed repeatedly on measures of short-term and long-term memory on and off the drug. Both kinds of memory, especially the latter, appeared detrimentally affected by the drug. However, dosage seemed to be inversely related to the degree of memory impairment. In general, the results are consistent with the hypothesis that diazepam interferes with the memory consolidation process. The negative relationship between drug dosage and degree of memory impairment might be due to habituation toward this particular side effect by heavier drug users. It is suggested that on theoretical grounds, the use of diazepam in conjunction with the behavioral psychotherapies may be contraindicated.
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PMID:The effect of diazepam on patients' memory. 647 Jan 92

Alzheimer's disease (AD) primarily results in memory impairment and cognitive deficits in areas such as language, visuospatial function, calculation, praxis and judgement. However, over 30% of patients with dementia develop a group of secondary behavioural disturbances, including depression, hallucinations and delusions, agitation, insomnia and wandering. Because these secondary symptoms impair patients' function, increase their need for supervision, and often influence the decision to institutionalise them, the control of these symptoms is a priority in managing AD. Psychotropic drugs, particularly antipsychotics (neuroleptics), have been a mainstay in treating many of these symptoms, but carry a high risk of adverse effects. Patients with AD may be particularly vulnerable to adverse effects of medications because of changes in pharmacokinetics and neurotransmitter systems, related to both AD and aging. At present, treating secondary symptoms of AD is more of an art than a science. For virtually every group of symptoms, older and newer classes of medications are available, with proven efficacy in patients without dementia and less clear results in AD patients. We review current treatment options and suggest preferences for each symptom complex, based on a trade-off between efficacy and adverse effects. New agents, such as selective serotonin reuptake inhibitors and atypical antipsychotics, may herald the arrival of symptom- (and receptor-) specific drugs with minimal adverse effects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Adjunctive therapy in patients with Alzheimer's disease. A practical approach. 757 86


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