Tag Archives: Ambien

Treatment of Insomnia

Several classes of medications are used in the treatment of insomnia. They include the benzodiazepines, non-benzodiazepine hypnotics, antidepressants, and over-the-counter medications. There are six benzodiazepines that are specifically marketed as hypnotics in the United States or in Canada: flurazepam, temazepam, triazolam, estazolam, quazepam, and (in Canada only) nitrazepam. Several other benzodiazepines (e.g., lorazepam, clonazepam, oxazepam),… Read More »

Current Therapies for Insomnia

Most individuals who suffer from insomnia either self-treat with nonprescription sleep aids (e.g., antihistamines, herbal remedies), use alcohol as a sedative, or take no drug therapy at all. For those who do seek professional help (approximately one-third of insomniacs), the majority receive physician-prescribed benzodiazepine or non-benzodiazepine sedative hypnotics to treat their insomnia. Such hypnotic agents… Read More »

Nonbenzodiazepine Hypnotics

Non-benzodiazepine hypnotics were introduced in most markets in the early 1990s. To date, three non-benzodiazepine hypnotics have been launched for insomnia — zolpidem, zopiclone, and zaleplon (Wyeth and King Pharmaceuticals’ Sonata). Characteristics that distinguish these drugs from traditional benzodiazepines (discussed later) are their increased receptor-binding specificity, favorable pharmacokinetics, and overall broader range of safety. More… Read More »

Emerging Therapies for Insomnia

Most of the late-stage compounds in clinical development for insomnia are non-benzodiazepine gamma-aminobutyric acid -acting agents. These drugs’ developers are hoping that their new compounds, once approved, will achieve less restrictive labeling from regulatory authorities than the currently marketed benzodiazepine and non-benzodiazepine hypnotics — most of which have short-term prescribing limits and all of which… Read More »

Nonbenzodiazepine GABA-A Agonists

As mentioned, non-benzodiazepine gamma aminobutyric acid-A agonists in clinical development are very similar in terms of mechanism of action, safety, and efficacy to the currently marketed non-benzodiazepine hypnotics zolpidem, zopiclone, and zaleplon (which are sometimes referred to as the “Z” drugs). Consequently, none of these clinical-stage compounds is likely to offer major benefits in terms… Read More »

Delirium (Acute Confusional State)

Description of Medical Condition Delirium is a neurologic complication of illness and/or medication use that is especially common in older patients. The key diagnostic features are an acute change in mental status that fluctuates, abnormal attention, and either disorganized thinking or altered level of consciousness. Delirium is a medical emergency requiring immediate evaluation in order… Read More »

Drugs Facilitating Sleep

Drugs of Choice for Insomnia Treatment The drug class of choice for the symptomatic treatment of insomnia is the benzodiazepine receptor agonist (National Institute of Mental Health, 1984). The class name is derived from the recognized mechanism of these drugs. Some have the benzodiazepine chemical structure, whereas others do not. However, they all share the… Read More »

Combining Behavioral and Pharmacological Treatments

Benzodiazepine hypnotics continue to be widely prescribed for insomnia (). Many patients who request treatment at sleep disorders centers are reluctant to withdraw from hypnotics for fear that their sleep will become substantially worse. This fear is not entirely unfounded; benzodiazepine withdrawal symptoms have been well documented and may last as long as 4 or… Read More »

Shift Work

It was mentioned in chapter 2 that Homo sapiens is a diurnal creature, endowed with biological processes that work under the assumption that the night will be taken up with sleep and the daytime with activity. This temporal orientation is accomplished by the generation of rhythms with a period of about 1 day, which are… Read More »