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)

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.
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PMID:Euhypnos Forte (temazepam) for resistant insomnia: a clinical trial. 3 57

1 Efficacy of temazepam 30 mg at night as an hypnotic was compared with placebo in 55 out-patients with insomnia. The study was double blind, with two comparable groups of patients established by random allocation. Placebo and medication were taken for 4 consecutive nights and sleep questionnaires were completed the next day. 2 Patients reported that temazepam was more effective than placebo in reducing the difficulty of falling asleep and improving sleep maintenance. They also indicated that they awoke less and were less disturbed by early morning awakenings reported as a group that the average duration of sleep was increased by 1 hour. 3 The patients receiving temazepam reported being more alert in the morning and for the entire day than with placebo.
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PMID:Double-blind evaluation of the safety and hypnotic efficacy of temazepam in insomniac outpatients. 4 44

1 In the management of insomnia with drugs, any action should be restricted to the duration of the night and residual effects should be absent during the day-time. The intermittent type of drug action desired is fundamentally different from drug treatment where a constant effect is sought. 2 Duration of drug action is dependent on the kinetics of distribution and elimination of the parent drug and its effective metabolites. In addition biopharmaceutical factors, such as those which promote a rapid rate of absorption, are important. 3 These considerations serve as a guide for a review of the kinetics and metabolism of various benzodiazepines.
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PMID:Pharmacokinetics and metabolism of various benzodiazepines used as hypnotics. 4 45

1 The efficacy and safety of temazepam 30 mg, compared with glutethimide 500 mg and placebo, were evaluated in double-blind conditions in a 4-day study in 75 outpatients with a history of insomnia. 2 Temazepam and glutethimide were rated by the patients as effective and significantly superior to placebo for general quality of sleep, time required to fall asleep, frequency of nocturnal and early morning awakenings, and duration of sleep. 3 Residual effects reported for temazepam and glutethimide immediately after awakening and during the day were similar to or less than those reported for placebo.
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PMID:Double-blind evaluation of the efficacy and safety of temazepam in outpatients with insomnia. 4 46

Of 23 hospitalized chronic schizophrenic patients, all under neuroleptic medication, hypnotics taken previously for a long time could be totally withdrawn in 16 cases, and in 7 cases, the dosage was diminished by 30%, without any sleep impairment. The gradual reduction of hypnotics was accompanied by a shift of neuroleptic dosage to the evening and bedtime, with reduction of the morning and midday dose, without change of the total daily dose. A significant improvement in the psychic state was observed in 16 patients after withdrawal of the hypnotic; 7 patients showed a slight improvement after reduction of the hypnotic. Monthly or bimonthly reassessment of insomnia in the hospitalized population of chronic schizophrenics is indispensable to avoid the deleterious effects and abuse of hypnotic drugs.
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PMID:The utilization of hypnotics in chronic schizophrenics: some critical remarks. 4 5

The term addictive as used by the popular press frequently confuses the more precise concepts of acute and chronic tolerance, physical dependence and withdrawal, and psychologic dependence. Serious physical dependence on psychoactive drugs is rare and is easily managed. In contrast, psychologic dependence, the most important reason for persistent drug use, is much more common and is difficult to treat. Some tactics are available - for example, confrontation and discussion with the patient about how a drug is not going to be effective over long periods. Treating the symptom of a complex problem should, of course, not be expected to solve the problem. The most important tactic is to prescribe dependence-associated drugs only when clearly indicated, when the problem is responsive to drug therapy and for the shortest period necessary, without the option for renewing the prescription. Many problems related to drug use long after the period of expected benefit is past can be avoided by far more restrictive drug prescribing. Barbiturates and nonbarbiturate sedative hypnotics (e.g., ethchlorvynol, glutethimide, meprobamate, methaqualone and methyprylon) should not be prescribed for insomnia, acute reactive anxiety, chronic anxiety neurosis or depressive illnesses, since the safer and equally effective benzodiazepines, which are less associated with dependence, are available.
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PMID:Use of drugs with dependence liability. 4 79

A sleep laboratory hypnotic drug evaluation study was conducted in which 2 mg flunitrazepam, a benzodiazepine with a half life of intermediate duration, was administered nightly to 6 insomniac subjects for 4 consecutive weeks. The drug was effective with short-term use. However, tolerance developed for sleep maintenance during the intermediate- and long-term drug administration periods. Following drug withdrawal, a significant worsening of sleep above baseline levels occurred. These data are consistent with our previous findings of rebound insomnia following withdrawal of short- and intermediate-acting benzodiazepines.
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PMID:Long-term sleep laboratory evaluation of flunitrazepam. 4 31

Sleep is affected in depression; insomnia is common, sleep of normal duration and hypersomnia less common. All-night studies have shown changes of the two types of sleep. Deep non-REM sleep is abolished during the course of the illness and sometimes also after remission. Paradoxical sleep, which may be reduced or increased in duration, starts sooner after the onset of sleep. According to Kupfler, ease of production of that sleep is specific to primary depression, unipolar or bipolar. A possible relationship between paradoxical sleep and certain types of depression is suggested by the fact that the tricyclic and MAOI antidepressant drugs and lithium reduce or suppress that sleep. Finally, deprivation of paradoxical sleep by repeated waking during the night has been put forward as a form of treatment. Despite the heterogeneous nature of depression, findings at present which show paradoxical sleep pressure provide a pathophysiological basis for the biological problems posed.
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PMID:[Depression and sleep (author's transl)]. 4 63

All night sleep EEG, EKG, and respiration were recorded from six young men during 2 nights at sea level and 4 nonconsecutive nights at high altitude (14.110 ft., 4301 m). Sleep at high altitude was chraacterized initially by a significant decrease in Stages 3 and 4, a significant increase in the number of arousals, and a trend towards more time spent awake. In terms of actual time spent sleep, however, a relatively good night's sleep was obtained, which suggests that the objective sleep disturbance was not commensurate with the marked subjective complaints of sleeplessness. Periodic respiration during sleep was frequent at high altitude, was quickly terminated by oxygen administration, was not clearly related to the increased number of arousals, and usually was not seen during REM periods. Heart rate was increased during sleep at high altitude. All measures tended to return towards sea level means during 12 days at altitude. We suggest that the marked increase in the number of arousals may account for the disparity between the subjective reports and objective measures of sleep disturbance at high altitude. Although the objective sleep disruption is probably related in some fashion to hypoxemia, it is unclear whether hypoxemia itself or the alkalosis commonly present shortly after arrival at altitude is the major factor.
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PMID:Sleep physiology at high altitude. 5 Jan 71

Intermittent hyperthyreosis occurs under various forms of stress, especially heat stress. The clinician may diagnose such cases as masked or apathetic hyperthyroidism or "forme fruste" hyperthyreosis or thyroid autonomy. As most routine and standard tests may here yield inconsistent results, it is the patients' anamnesis which may provide the clue. Our Bioclimatology Unit has now seen over 100 cases in which thyroid hypersensitivity towards heat was the most prominent syndrome: 10-15% of weather-sensitive patients are affected. The patients complain before or during heat spells of such contradictory symptoms as insomnia, irritability, tension, tachycardia, palpitations, precordial pain, dyspnoe, flushes with sweating or chills, tremor, abdominal pain or diarrhea, polyuria or pollakisuria, weight loss in spite of ravenous appetite, fatigue, exhaustion, depression, adynamia, lack of concentration and confusion. Determination of urinary neurohormones allows a differential diagnosis, intermittent hyperthyreosis being characterized by three cardinal symptoms: 1. tachycardia -- every case with more than 80 pulse beats being suspect (not specific); 2. urinary histamine -- every case excreting more than 90 mug/day being suspect. Again the drawback of this test is its lack of specificity, as histamine may also be increased in cases of allergy and spondylitis; 3. urinary thyroxine -- every case excreting more than 20 mug/day T-4 being suspect. This is the only specific test. Therapy should make use of lithium carbonate and beta-blockers. Propyl thiouracil is rarely required.
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PMID:Intermittent hyperthyreosis -- a heat stress syndrome. 5 84


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