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)

Seventy insomniac patients, previously unresponsive to conventional hypnotic dosage, were treated for seven nights with temazepam in 20 mg soft gelatin capsules (Euhypnos Forte). The patients adjusted the dose to suit themselves up to a maximum of 60 mg. Nineteen patients found that one 20 mg capsule suited them best in spite of previous lack of response to two 10 mg capsules, and were thus excluded from the final analysis. Out of the remaining fifty-one patients, thirty-five were best suited by 40 mg and sixteen by 60 mg of temazepam. Sleep was rated Very Good or Good by forty patients (78.4%) and significant hangover occurred in only four (7.8%), all of whom were on 40 mg. Adverse reactions were insignificant. Some observations by one author (CALM) on the significance of the results in the management of insomnia in general practice are included.
 ...
PMID:Euhypnos Forte (temazepam) for resistant insomnia: a clinical trial. 3 57

Alcohol withdrawal syndromes in humans lie on a continuum of increasing severity, from the acute hangover to delirium tremens. Early mild reactions consist primarily of hyperexcitability phenomena such as tremor, insomnia, hyperreflexia and hyperventilation. In more severe degree, the same process gives rise to hallucinations and seizures. These early reactions are mimicked closely by alcohol withdrawal signs in experimental animals. Late reactions in humans are characterized by marked sympathetic nervous system overactivity, profound disorientation and hallucinations. Analogous reactions have not yet been observed clearly in other species. The problem may be one of finding appropriate techniques for detecting such changes, rather than a true species difference in their occurrence.
 ...
PMID:Alcohol withdrawal syndromes in the human: comparison with animal models. 33 82

Thirty patients complaining of insomnia were studied in a double-blind trial with crossover of Finorgal, nitrazepam and triclofos sodium. Finorgal given as a hypnotic produced similar results to nitrazepam and triclofos sodium in terms of induction of sleep, duration and quality of sleep, dream recall and morning 'hangover'. Reported side-effects were not serious and occurred less frequently in association with Finorgal treatment than with nitrazepam or triclofos sodium. Laboratory investigations gave no indication of the development of any drug toxicity during the three-week period of the trial.
 ...
PMID:Comparative trial of a new hypnotic (Finorgal) with nitrazepam and triclofos sodium. 38 91

1 To assess the potential hazards of nitrazepam therapy of insomnia in the elderly, adverse reactions to nitrazepam were studied in 2111 hospitalized medical patients who received the drug. 2 Manifestations of unwanted central nervous system (CNS) depression (such as drowsiness or 'hangover') were reported in 49 nitrazepam recipients (2.3%), and signs of unwanted CNS stimulation (such as nightmares, insomnia, agitation, etc.) in 15 (0.7%). None of the adverse reactions were considered serious. 3 Physician-rated clinical efficacy of nitrazepam was not related to dose, but the frequency of both types of adverse reactions increased significantly at higher daily doses. CNS depression also was significantly more frequent in the elderly, being reported in 11% of those aged 80 years or older, whereas the frequency of CNS stimulation was not correlated with age. 4 The effect of age on the reported rate of unwanted CNS depression was most striking at high doses. Among patients aged 80 years or over whose daily dose averaged 10 mg or more, 55% experienced unwanted CNS depression attributed to nitrazepam. 5 Low doses of nitrazepam are safe for elderly individuals, but the elderly are readily susceptible to excessive CNS depression at high doses. The findings suggest that there is little reason to exceed 5mg doses of nitrazepam for most patients, particularly those who are elderly.
 ...
PMID:Toxicity of nitrazepam in the elderly: a report from the Boston Collaborative Drug Surveillance Program. 65 80

The aetiology of insomnia can be conveniently divided into six groups: physical (pain, cough, etc.), physiological (shift-workers etc.), psychological (life events), psychiatric (depression, anxiety, etc.), iatrogenic (stimulant drugs, etc.) and idiopathic (no obvious cause). The four main types of insomnia are: prolonged latency, frequent short awakenings, one or two long awakenings and early morning awakening. Patients' habits that may interfere with sleep are related to: alcohol, smoking, tea and coffee drinking, and bedtime drinks. In a double-blind comparison between temazepam and nitrazepam, both drugs were shown to be effective hypnotics, nitrazepam being better for early morning wakening, although at the expense of more hangover effects. Zopiclone, a new cyclopyrrolone hypnotic, was also compared to temazepam in a double-blind cross-over trial and similar hypnotic effects were recorded with both drugs.
 ...
PMID:Insomnia in general practice: the role of temazepam and a comparison with zopiclone. 288 21

Benzodiazepines are the most frequently prescribed drugs in the Western world. About 3% of the adult Swiss population regularly use benzodiazepines for the treatment of anxiety states or for induction of sleep. All benzodiazepine agonists available exert qualitatively similar pharmacodynamic actions. They commonly activate central GABAergic neuroinhibition, thereby inducing anxiolysis, sedation/hypnosis, anticonvulsion and muscle relaxation. However, various derivatives differ in their physicochemical and pharmacokinetic properties such as lipophilicity, rate of gastrointestinal absorption, hepatic biotransformation and elimination half life. These differences among individual substances can be used clinically to optimize therapy for the individual patient. For example, the elimination half life greatly influences the frequency, intensity and type of adverse reactions such as hangover, rebound insomnia, development of tolerance and dependence as well as withdrawal symptoms. It is estimated that "low-dose dependency" develops in as many as 30 to 45% of chronically treated patients. Low-dose dependency is mainly characterized by the appearance of withdrawal symptoms after cessation of therapy. Since management of the withdrawal state is difficult and especially troublesome for the patient it is best to prevent the development of benzodiazepine dependence by prescribing these drugs less and restricting them to short-term use (7-14 days).
 ...
PMID:[Benzodiazepine--practice and problems of its use]. 328 2

Chlormethiazole has sedative, hypnotic and anticonvulsant properties, and is used in the treatment of sleep disorders and confusion in the elderly. In this study we examined the effects of chlormethiazole on EEG recorded sleep in six normal volunteers aged 67-74 years. After baseline registration, chlormethiazole (base), 384 mg p.o. (i.e. 2 capsules), was administered during 5 nights followed by one withdrawal registration. Sleep latency decreased from 52 to 27 min during the treatment period (P less than 0.01) and increased to 57 min during withdrawal. Wakeful periods during sleep decreased from 106 to 62 min during the treatment period and increased during withdrawal to 104 min (P less than 0.001). The sleep efficiency improved slightly during chlormethiazole treatment. The distribution of the sleep stages was essentially unaffected by chlormethiazole. According to subjective assessment the subjects rated their ability to fall asleep and their sleep quality as significantly better during the drug period. Based on sleep recordings and subjective ratings, there was no evidence of rebound insomnia on withdrawal. Psychoperformance tests revealed no evidence of hangover effects.
 ...
PMID:The effects of chlormethiazole in EEG recorded sleep in normal elderly volunteers. 346 56

Flunitrazepam is a benzodiazepine derivative whose hypnotic effect predominates over the sedative, anxiolytic, muscle-relaxing and anticonvulsant effects characteristic of benzodiazepines. Thus, it is used as a night-time hypnotic and in anaesthesiology: due to the pronounced hypnotic effect it is not appropriate as a daytime sedative. As a hypnotic for insomnia its effect is usually characterised by a very fast onset of action and quiet sleep without interruptions. On the morning after a hypnotic dose some residual psychomotor impairment does occur, which is comparable to that with usual doses of nitrazepam or flurazepam, but clinically apparent 'hangover' occurs infrequently. There is no pronounced cumulative effect with chronic use. In anaesthesiology it has proven to be useful as a hypnotic on the night before operation, as an oral, intramuscular or intravenous premedication, in induction and as a supplement to other anaesthetics. Its sedative and amnesic properties can also be beneficial in intensive care patients. Much of the usefulness of flunitrazepam in anaesthesia relates to its synergistic effect with other anaesthetics, to its effective amnesic action and its acceptable effects on circulation and respiration. Possible drawbacks include a somewhat unusual course of induction (when used for this purpose) and an often prolonged recovery. Although the safe dosage range is wide with flunitrazepam, its effective application both as a hypnotic for insomnia and in anaesthesiology is dependent upon use of the optimal dosage, and adequate knowledge of its pharmacokinetic properties.
 ...
PMID:Flunitrazepam: a review of its pharmacological properties and therapeutic use. 610 5

A post-marketing surveillance study of Euhypnos Forte (temazepam 20 mg) capsules for the treatment of insomnia in 10,057 patients previously unresponsive to other hypnotics given in conventional doses. Patients were prescribed a nightly dose of 40 or 60 mg, but 95% actually took 40 mg. At 2 weeks, 89% of patients found the treatment effective, as did 95% at 3 months. Hangover, severe enough to stop treatment, occurred in less than 3% of patients, and other adverse reactions such as headache, dreams, gastrointestinal disturbance and hangover symptoms were reported by only 6% of patients at 2 weeks and 4% at 3 months. The most common reason for stopping treatment was the patient having no further need for hypnotics. Euhypnos Forte was effective in 88% of 3,800 patients who had found nitrazepam unsatisfactory and 90% of 1,013 patients unresponsive to barbiturates.
 ...
PMID:Euhypnos forte, high dose temazepam for resistant insomnia: post-marketing surveillance in 10,057 patients unresponsive to conventional hypnotic dosage. 610 67

In a double-blind, placebo-controlled study the effect of nocturnal traffic noise and bedtime medication of a new benzodiazepine, OX-373, on objective and subjective sleep variables as well as on the quality of morning awakenings was investigated. 10 healthy subjects spent 17 nights in the sleep laboratory: 2 adaptation nights, 1 baseline night, 4 drug nights (20, 30, and 40 mg OX-373 and placebo) and 4 subsequent wash-out nights as well as 3 nights under traffic noise with placebo, 30 and 40 mg OX-373 and 3 subsequent wash-out nights. Nocturnal traffic noise with an intensity of 45-65 dB(A) induced sleep disturbances characterized by an increase in intermittent wakefulness and stage 1 and the number of nocturnal awakenings as well as by a decrease of spindle and REM sleep stages. Subjectively, a decrease of deep sleep and increase of light sleep and middle insomnia was reported. Upon awakening in the morning, mood was significantly deteriorated. The new benzodiazepine OX-373 attenuated the above-described traffic noise-induced changes and produced even oppositional alterations, such as a decrease in stage 1, number of awakenings and stage shifts while increasing stage 2. The drug alone decreased the number of awakenings and stage 1 and augmented stage 4 as compared with placebo, which was subjectively felt as an increase in deep sleep and as a decrease of light sleep, early and middle insomnia. In the morning, there were no signs of 'hangover', which was confirmed also by psychometry. Nor were there any clinically relevant alterations in blood pressure and pulse. Thus, our studies confirmed earlier pharmaco-EEG and psychometric investigations predicting OX-373 as well-tolerated anxiolytic sedative, and suggested further that traffic noise could eventually be utilized as an experimental provocative technique in order to induce a standardized sleep disturbance for early clinical drug evaluation of potentially hypnotic substances.
 ...
PMID:Traffic noise-induced sleep disturbances and their correction by an anxiolytic sedative, OX-373. 611 40


1 2 3 4 Next >>