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)

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

We studied sleep and daytime function in insomniac patients who took either flurazepam, 30 mg, triazolam, 0.5 mg, or placebo 30 minutes before bedtime. Subjects were 21 patients with either a primary or a secondary diagnosis of chronic psychophysiological insomnia or insomnia associated with personality disorder. Seven subjects were randomly assigned to each condition. The study used a three group by 9 week, double-blind design with three nocturnal sleep recordings each week. During week 1, subjects took no capsules; week 2, subjects took placebo; weeks 3 to 7, flurazepam, triazolam, or placebo; weeks 8 and 9, placebo. Daytime tests for alertness and performance were administered during weeks 1, 3, 5, 7, and 8. Flurazepam showed hypnotic efficacy for weeks 3 to 5. Triazolam showed hypnotic activity for weeks 3 to 7. Although not significant overall, discontinuation of flurazepam produced rebound insomnia in six of seven subjects sometime during the two withdrawal weeks. The relationship between plasma concentration of desalkylflurazepam, the principal active metabolite of flurazepam, and sleep disturbance suggested that the onset of the rebound insomnia depended on the rate of drug washout. Discontinuation of triazolam produced a significant rebound insomnia on the first and second nights of drug withdrawal. Placebo subjects showed improved sleep throughout weeks 2 to 9 of the study. Daytime testing revealed significantly decreased daytime alertness and decreased performance for flurazepam subjects during weeks 3 to 7, although these effects reverted toward baseline despite continued drug administration.
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PMID:Comparative hypnotic effects of flurazepam, triazolam, and placebo: a long-term simultaneous nighttime and daytime study. 614 Nov 88

Three benzodiazepine derivatives are currently indicated specifically for the treatment of insomnia in the United States. Flurazepam is biotransformed to at least two rapidly appearing and rapidly eliminated intermediate metabolites which probably contribute to sleep induction. The final metabolite, desalkylflurazepam, appears slowly, but has a long half-life ranging from 40 to 150 h. This metabolite accumulates extensively during multiple dosage. Temazepam is a slowly absorbed drug and has an intermediate half-life in the range of 10-20 h. Triazolam has an intermediate absorption rate, but is rapidly eliminated (half-life 1.5-5 h) making it essentially non-accumulating. Understanding of the pharmacokinetics of benzodiazepine hypnotics can contribute to understanding of their clinical properties.
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PMID:Pharmacokinetics of benzodiazepine hypnotics. 614 69

Three benzodiazepine derivatives are currently indicated specifically for the treatment of insomnia in the United States. Flurazepam is biotransformed to at least two rapidly appearing and rapidly eliminated intermediate metabolites which probably contribute to sleep induction. The final metabolite, desalkylflurazepam, appears slowly, but has a long half-life ranging from 40 to 150 h. This metabolite accumulates extensively during multiple dosage. Temazepam is a slowly absorbed drug and has an intermediate half-life in the range of 10-20 h. Triazolam has an intermediate absorption rate, but is rapidly eliminated (half-life 1.5-5 h) making it essentially non-accumulating. Understanding of the pharmacokinetics of benzodiazepine hypnotics can contribute to understanding of their clinical properties.
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PMID:Pharmacokinetics of benzodiazepine hypnotics. 614 83

This study is a double-blind comparative trial of flurazepam and temazepam in the treatment of insomnia, using subjective assessments with an analogue scale technique and questionnaire. The main dependent variable in this experiment is vigilance. The two drugs differ essentially in their half life value. (Flurazepam +/- 72 h; temazepam +/- 8 h). It can be predicted that temazepam causes less impairment of vigilance than flurazepam, and that the difference between the two drugs is more pronounced when the number of days the drugs are taken consecutively, increases. In statistical terms an interaction effect between drugs and days should be expected. The results show no effect at all, neither the predicted interaction effect, nor any main effect. If there is a difference in efficiency reduction between patients, the assessment methods used were unable to measure it. These findings warn against a possible overestimation of clinical relevance of the plasma elimination half-life of benzodiazepines.
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PMID:Flurazepam and temazepam in the treatment of insomnia in a general hospital population. 614 66

Insomnia--the chronic inability to obtain the amount and quality of sleep needed for effective daytime function--is a common subjective complaint. Several major causes exist, and many strategems can be used in management. When drugs are indicated, the benzodiazepines are the first choice. Flurazepam, a long-acting compound, has recently been complemented by temazepam, a shorter-acting hypnotic. The pharmacokinetics, actions, and clinical uses of temazepam are reviewed. It is concluded that temazepam is preferable where daytime alertness must be unimpaired, with flurazepam reserved for patients who need daytime sedation.
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PMID:Insomnia and short-acting benzodiazepine hypnotics. 682 30

The clinically observed results in 40 patients, from 1 to 15 years old, presenting sleep disturbances, in a comparative and statistically approached study of flurazepam 15mg daily against placebo, are reported. Placebo was administered, followed by the drug, during 14 days each. The chief complaints were sleepwalking, sleep-talking, sleep terror, sleep-related bruxism, sleep-related headbanging, insomnia and excessive movements during sleep. A significant effect of flurazepam on sleepwalking, sleep-talking, bruxism, sleep terror and excessive movement during sleep, was observed. The insomniac headbanging patients were not enough for statistical analysis. Flurazepam side effects were excessive drowsiness during daytime in 3 cases; irritability, 3 cases; nausea and vomiting, 2 cases, and were not correlated with age. Placebo side effects were similar, except for nausea and vomiting which were not observed. It was necessary to discontinue flurazepam in 2 cases, because of excessive drowsiness during daytime, which did not improve when reducing the dose.
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PMID:Evaluation of flurazepam and placebo on sleep disorders in childhood. 704 99

The short-term hypnotic efficacy of 15 mg flurazepam was evaluated in nine patients (mean age 37.2 +/- 15.9 years) who complained of insomnia and had polysomnographic evidence of disturbed sleep. Patients slept in the laboratory 14 consecutive nights, and their sleep was monitored using standard polysomnographic procedures. Prior to bedtime, they received a placebo the first four nights, 15 mg flurazepam on nights 5 through 11, and a placebo again on nights 12 through 14. Flurazepam significantly increased total sleep time while reducing the latency to stage 1 sleep, the number of awakenings in the night, and the amount of wakefulness after sleep onset. Sleep stage patterns also were altered significantly with flurazepam: percentage stage 2 sleep increased, and percentages of 3-4 sleep and REM sleep (on drug night 1 and nights 1-3) decreased. With the exception of REM sleep, most of these drug effects were first detected on the second night of administration, did not diminish over the next six nights, and persisted during the three-day withdrawal period. Subjective evaluations of sleep generally corresponded with the polysomnographic data. It was concluded that 15 mg flurazepam has significant hypnotic properties with minimal adverse side effects.
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PMID:Flurazepam for short-term treatment of complaints of insomnia. 710 76

A meta-analysis was done of the published literature concerning the modern status of the issue of sleep disturbances and of findings from the author's investigations. Data are submitted obtained in a clinical examination of 61 elderly patient in a therapeutical hospital. In the above patients, high prevalence has been revealed of different sleep disturbances. Insomnia is often a sequela of psychophysiological derangements, which fact necessitates an exhaustive differential diagnosis and choice of remedies to be used in therapy of the above disorders. An experience is described of employment of zopiclon (Somnol Grindex) to deal with sleep problems in those patients in the involutional period. It is suggested that psychiatrist services be more actively used to give the necessary advice to those patients of the cardiological profile presenting with sleep disturbances.
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PMID:[Diagnostics and treatment of sleep disorders in elderly people]. 1288 68

Based upon the conception of "circular-type addiction" scientists mark out psychological (alexithimia), psychopathological (anxiety and depressive disorders), neurological (insomnia) and somatic (circulator disturbances) levels in pathogenesis of arterial hypertension. Sleep disorder have been noted to be a key symptom in phenomenology of arterial hypertension therefore it is recommended giving Somnol as an adjuvant remedy for treatment of arterial hypertension.
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PMID:[Diagnostics and treatment of insomnia with concomitant arterial hypertension. Use of somnol as an adjuvant remedy]. 1531 37


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