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)

Sixty-two elderly in-patients suffering from insomnia were studied in a double-blind, double-dummy, placebo-controlled trial. Each group received either lormetazepam 1 mg, chlormethiazole 384 mg or placebo for 7 nights. Both lormetazepam and chlormethiazole significantly increased sleep duration, reduced sleep latency and improved quality of sleep and feelings on awakening. For both drugs, reaction times the next morning were unimpaired and there was no clinical evidence of accumulation after 7 nights continuous dosing. Lormetazepam and chlormethiazole in these doses are effective and safe hypnotics for frail elderly patients.
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PMID:A comparative study of lormetazepam and chlormethiazole in elderly in-patients. 355 51

1 The effects of lormetazepam and camazepam on sleep electroencephalography, visuo-motor coordination, digit symbol substitution and subjective assessments of mood and sleep quality were compared with placebo in six young adult males (18-27 years). The study was double blind. 2 Over the dose range 0.5, 1.0 and 2.0 mg, lormetazepam increased total sleep time (P less than 0.05), reduced wakefulness (P less than 0.05) and drowsy sleep (linear effect P less than 0.05). With 2.0 mg there were increases in stage 3 (P less than 0.05) and reduction in rapid eye movement sleep (P less than 0.01). Overnight ingestion of 2.0 mg, was followed by impaired visuo-motor coordination and fewer substitutions with the digit symbol test. 3 The hypnotic effect of 10-20 mg camazepam was limited to reduced awake activity (P less than 0.05), and with 20 mg there were increased substitutions on the digit symbol test. After 40 mg overnight stage 4 sleep was reduced (P less than 0.001) and performance at the digit symbol test was impaired (P less than 0.05 at 9.75 h). Morning ingestion of 20 mg camazepam did not alter performance, and the subjects assessed themselves to be more relaxed. 4 Lormetazepam is not specially indicated for those involved in skilled activity, but may prove useful for patients with insomnia resistant to other drugs. Camazepam would appear to be a promising anxiolytic with minimal effects on performance.
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PMID:Hypnotic activity and effects on performance of lormetazepam and camazepam--analogues of temazepam. 612 Jul 17

Lormetazepam, an investigational hypnotic, was evaluated for efficacy and withdrawal phenomena in doses of 0.5, 1.0, 1.5, and 2.0 mg in four separate sleep laboratory protocols, each including four placebo baseline nights, seven drug nights, and three placebo withdrawal nights. A moderate degree of efficacy was shown across the four doses, but this was quite variable. There was no dose-response effect for efficacy for either the first three or last three nights of this short-term administration period. In general, there was less efficacy on the later drug nights, indicating a potential for the development of tolerance over a relatively short period of time. Following drug withdrawal, there was a dose-related worsening of sleep above baseline levels (rebound insomnia). The peak degree of worsening of sleep following drug withdrawal was more than two times greater than the peak degree of improvement of sleep with drug administration.
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PMID:Dose-response studies of lormetazepam: efficacy, side effects, and rebound insomnia. 613 Oct 80

In a double-blind clinical trial, 50 psychiatric outpatients with moderate insomnia (requiring daily treatment with a hypnotic drug) were treated for two weeks with lormetazepam (1 mg) or amobarbital sodium (100 mg). In interviews before and after treatment, data were collected on the patients' demographic characteristics, sleep disturbances, concomitant organic or psychiatric disorders, and opinions of the drug taken during the two-week period. During the trial the patients took notes on their use of the drug, the quality and duration of their sleep, and any adverse effects of the drug they were using. Lormetazepam and amobarbital were equivalent in the amount of time it took patients receiving each drug to fall asleep and in the duration of the patients' sleep, but insomnia disappeared (or the condition improved) in a larger proportion of patients receiving lormetazepam, and there were fewer adverse effects (eg, hangover in the morning, sedation in the morning and during the day, and dry mouth) in patients receiving lormetazepam than in patients receiving amobarbital.
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PMID:Lormetazepam and amobarbital sodium in the outpatient treatment of insomnia: a controlled trial. 613 7

Lormetazepam is a new benzodiazepine hypnotic. Previous work has indicated that lormetazepam has an intermediate to short elimination half-life, i.e. in the range of 5-15 h. Hence, in older patients, the drug should be safe and hypnotically active in doses equal to or less than the doses recommended for young adults. The present study tested this hypothesis. We studied ten healthy subjects, aged 55 and older, with both subjective and objective insomnia. Subjective insomnia was the complaint of requiring at least 45 min to fall asleep and sleeping less than six and a half hours per night. Each complaint was present on at least 50% of the nights for at least three months. Objective insomnia was measured polysomnographically and was present on at least two of the last three nights of four consecutive nights of placebo baseline. The study involved a design in which treatment was administered in a double-blind fashion. Each subject was studied for 14 consecutive nights in the sleep laboratory. The drug was administered for seven consecutive nights which were preceded by a placebo baseline and followed by a placebo period of drug withdrawal. On each laboratory night subjects were monitored by continuous, all-night conventional EEG/EOG/EMG recordings. Each laboratory morning subjects completed a questionnaire on which they rated six characteristics of their sleep on the previous night. At study entry and again at study end, each subject had a physical examination by a Board internist and clinical laboratory tests. Each laboratory morning and evening subjects had a screening physical exam and completed an 11-item hypnotic drug side-effect questionnaire and a 56-item review of medical systems questionnaire. Compared with the median baseline night, on the median drug night lormetazepam 0.5 mg significantly increased total sleep time by about 25 min. The drug's reductions of sleep latency were substantial. In addition, lormetazepam 0.5 mg significantly decreased number of awakenings. No objective evidence was found of either tolerance developing to the hypnotic efficacy of lormetazepam 0.5 mg or of rebound insomnia.
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PMID:Sleep laboratory study of lormetazepam in older insomniacs. 614 42

Lormetazepam (1 and 2 mg) was tested against flurazepam (30 mg) and placebo in 60 patients (15 per treatment group) with initial, intermediate, or late insomnia. Patients were randomly assigned to treatment groups, and a double-blind protocol was followed. The four-week study included one week of use of the placebo, followed by two weeks of treatment with the active drug (in three groups) or continued use of the placebo (one group), and one week of use of the placebo (all four groups). Results showed that the active drugs were efficient in controlling insomnia. In some subjective parameters, only 2 mg of lormetazepam was significantly better than placebo. Tolerability of the drugs was considered good, with no interruption of treatment required because of adverse reactions. There was a rebound effect in one patient receiving 1 mg of lormetazepam and in three patients receiving flurazepam.
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PMID:Comparative study of lormetazepam and flurazepam in the treatment of insomnia. 638 Jul 24

In recent years, sedating antidepressants have been increasingly used to treat primary insomnia. Up to now, only one open pilot study with trimipramine and one double-blind placebo-controlled study with doxepin have provided scientific support for this approach in treating primary insomnia. In order to test the hypothesis that sedating antidepressants are useful in the treatment of primary insomnia, the effect of trimipramine on objectively and subjectively measured parameters of sleep was investigated in a double-blind placebo- and lormetazepam-controlled study in a sample of 55 patients with primary insomnia attending outpatient sleep-disorder clinics. Trimipramine was selected since it has shown positive effects on sleep continuity with a lack of REM sleep suppression in studies on depressed patients and in one pilot study on patients with primary insomnia. Trimipramine at an average dose of 100 mg over a period of 4 weeks significantly enhanced sleep efficiency, but not total sleep time (which had been the primary target variable) compared to placebo as measured by polysomnography. Changes in objective sleep parameters were paralleled by changes in subjective sleep parameters. Trimipramine did not suppress REM sleep. Lormetazepam decreased wake time and sleep stage 3 and increased REM sleep compared to placebo. After switching trimipramine to placebo, sleep parameters returned to baseline. There was no evidence of any rebound effect from trimipramine. Side effects from trimipramine were only marginal. This first double-blind placebo-controlled study with trimipramine suggests its efficacy in the treatment of primary insomnia. However, due to the large intra- and interindividual variance in the parameters of interest before and during treatment a larger sample size would have been necessary to strengthen the validity of our findings.
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PMID:Trimipramine in primary insomnia: results of a polysomnographic double-blind controlled study. 1223 87

Lormetazepam is a short-acting benzodiazepine hypnotic which is beneficial in shortening the time to onset of sleep. The aim of the study was to assess a new formulation of lormetazepam (oral solution) in comparison with lormetazepam tablets in out-patients with insomnia. This trial was an open randomized parallel group study conducted by 30 general practitioners. One hundred and eight patients took 0.5 mg on the first night and were allowed to increase their dosage by 0.25 mg (for oral solution) and 0.5 mg (for tablets), respectively, each day and every 2 days. The patients assessed the efficacy, acceptability and tolerance of lormetazepam using a diary card and a set of visual analogue scales assessing their sleep. Over 14 days of treatment, the mean daily dose of lormetazepam was lower in the oral solution group than in the tablets group (0.78 mg versus 0.97 mg). The cumulated dose of lormetazepam was lower with the oral solution (18% reduction). No significant difference between the two groups was found in the assessment of sleep characteristics. The occurrence of side effects did not differ between the two groups. These results suggest that a unitary dose as achieved by an oral solution of lormetazepam allows easier determination of the minimal individual effective dose.
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PMID:A randomized clinical trial comparing doses and efficacy of lormetazepam tablets or oral solution for insomnia in a general practice setting. 1499 24

Lormetazepam (Loramet is a benzodiazepine mainly used as an hypnotic to treat insomnia. Lorazepam (Temesta) is used as an anxiolytic, tranquilizer, sedative, and anticonvulsant, and it is the major metabolite of lormetazepam. In this study, we designed a method to simultaneously detect and quantify these substances in human breast milk. Solid-phase extraction of 2 mL of milk was followed by derivatization with a trimethylsilyl reagent. Separation and detection was performed using gas chromatography coupled to mass spectrometry in the negative chemical ionization mode. Calibration curves were linear in the ranges of 10-200 and 1-20 ng/mL for lorazepam and lormetazepam, respectively. Limits of detection were estimated at 0.016 ng/mL for lormetazepam and 0.100 ng/mL for lorazepam. Our method was applied to real case samples from a woman receiving both benzodiazepines. Lorazepam concentrations varied from 55.3 to 123.1 ng/mL, and lormetazepam concentrations varied from 1.7 to 7.3 ng/mL.
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PMID:Quantification of lorazepam and lormetazepam in human breast milk using GC-MS in the negative chemical ionization mode. 1755 47