Tag Archives: Zolpidem

Pharmacological Treatment of Dementia

General guidelines for psychotropic medication use in frail elderly patients are applicable. Systematic evidence to support the effectiveness of particular psychotropic drugs in dementia patients is limited. Therefore, choice of drug class may be based on clinical evidence, and choice of agent is often based on the side-effect profile and on the characteristics of a… Read More »

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 »

Benzodiazepine Hypnotics

Benzodiazepine hypnotics can be categorized into three groups based on their pharmacokinetic characteristics: short-acting, intermediate-acting, and long-acting. Short-acting benzodiazepines such as triazolam (Pfizer’s Halcion, generics) generally have elimination half-lives of 6 hours or less; intermediate-acting benzodiazepines such as temazepam (Mallinckrodf s Restoril, generics), oxazepam (Wyeth’s Serax / Serepax, Boehringer-Ingelheim’s Adumbran, generics), and lormetazepam (Wyeth’s Loramet,… 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 »

Sleep-Related Breathing Disorder and Snoring

Sleep-related breathing disorder comprises obstructive sleep apnea, central sleep apnea, and obesity hypoventila-tion syndrome. Obstructive sleep apnea is the most notable of these conditions because of its high prevalence and association with numerous medical conditions if untreated. Obstructive apnea is defined as cessation of airflow that lasts at least 10 seconds owing to impedance of… Read More »

Treatment of Anxiety in the Medically Ill

Psychotherapy An overemphasis on psychopharmacology in the care of medically ill patients may result in overlooking the value of psychotherapy. The first step in the treatment of anxiety is to spend time listening to and talking with the patient. Just as in psychotherapy with any patient, empathic listening is a powerful tool to relieve distress.… Read More »