Pharmacologic Treatment of Insomnia Disorder: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians.
Conclusion: Eszopiclone, zolpidem, and suvorexant may improve short-term global and sleep outcomes for adults with insomnia disorder, but the comparative effectiveness and long-term efficacy of pharmacotherapies for insomnia are not known. Pharmacotherapies for insomnia may cause cognitive and behavioral changes and may be associated with infrequent but serious harms.
Primary Funding Source: Agency for Healthcare Research and Quality.
PMID: 27136278 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - May 2, 2016 Category: Internal Medicine Authors: Wilt TJ, MacDonald R, Brasure M, Olson CM, Carlyle M, Fuchs E, Khawaja IS, Diem S, Koffel E, Ouellette J, Butler M, Kane RL Tags: Ann Intern Med Source Type: research
Nonbenzodiazepine Sedative Hypnotics and Risk of Fall-Related Injury
Conclusions:For the treatment of insomnia in older adults, eszopiclone may present a safer alternative to zolpidem, in terms of fall-related injuries.Citation:Tom SE, Wickwire EM, Park Y, Albrecht JS. Nonbenzodiazepine sedative hypnotics and risk of fall-related injury. SLEEP 2016;39(5):1009–1014. (Source: Sleep)
Source: Sleep - April 29, 2016 Category: Sleep Medicine Source Type: research
Suvorexant: efficacy and safety profile of a dual orexin receptor antagonist in treating insomnia.
Authors: Owen RT
Abstract
Suvorexant is a hypnotic representing the first-in-class of a new group of agents known as dual orexin receptor antagonists. They target cerebral orexin receptors which, when activated, contribute to arousal and wakefulness. Suvorexant was shown to decrease sleep onset times and increase sleep duration, whether assessed objectively by polysomnography or subjectively by sleep diaries in primary insomnia patients. Overall tolerability was good, with somnolence being the commonest adverse event (≤ 7% in 3-month studies). No strong signals for rebound or withdrawal were seen after 1...
Source: Drugs of Today - March 5, 2016 Category: Drugs & Pharmacology Tags: Drugs Today (Barc) Source Type: research
Inhibition of Orexin Signaling Promotes Sleep Yet Preserves Salient Arousability in Monkeys
Conclusions:In nonhuman primates, DORAs' targeted mechanism for promoting sleep protects the ability to selectively arouse to salient stimuli and perform attentional tasks unimpaired, suggesting meaningful differentiation between a hypnotic agent that works through antagonizing orexin wake signaling versus the sedative hypnotic effects of the GABAaR modulator mechanism of action.Citation:Tannenbaum PL, Tye SJ, Stevens J, Gotter AL, Fox SV, Savitz AT, Coleman PJ, Uslaner JM, Kuduk SD, Hargreaves R, Winrow CJ, Renger JJ. Inhibition of orexin signaling promotes sleep yet preserves salient arousability in monkeys. SLEEP 2016;3...
Source: Sleep - March 1, 2016 Category: Sleep Medicine Source Type: research
Emerging role of orexin antagonists in insomnia therapeutics: An update on SORAs and DORAs.
Abstract
The pharmacological management of insomnia has lately become a challenge for researchers worldwide. As per the third International Classification of Sleep disorders (ICSD-3) insomnia can be defined as a state with repeated difficulty in sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for sleep, and results in some form of daytime impairment. The conventional treatments approved for management of insomnia were benzodiazepines (BZDs) (estazolam, quazepam, triazolam, flurazepam and temazepam) and non-BZDs, also known as z-drugs (zaleplo...
Source: Pharmacological Reports - February 29, 2016 Category: Drugs & Pharmacology Authors: Kumar A, Chanana P, Choudhary S Tags: Pharmacol Rep Source Type: research
Eszopiclone versus zopiclone in the treatment of insomnia
CONCLUSION: Based on the Insomnia Severity Index at the end of four weeks of treatment, eszopiclone demonstrated efficacy comparable to that of zopiclone in the treatment of insomnia, increasing total sleep time as well as sleep efficiency according to polysomnography. (Source: Clinics)
Source: Clinics - February 5, 2016 Category: Journals (General) Source Type: research
Pharmacology for sleep disturbance in PTSD
Symptoms of sleep disturbance, particularly nightmares and insomnia, are a central feature of post‐traumatic stress disorder (PTSD). Emerging evidence suggests that specific treatment of PTSD‐related sleep disturbance improves other symptoms of the disorder, which in turn suggests that such disturbance may be fundamental to development and maintenance of the disorder. This mini‐review focuses on pharmacological treatment of sleep disturbance in adult PTSD (specifically, studies testing the efficacy of antidepressants, adrenergic inhibiting agents, antipsychotics and benzodiazepine and non‐benzodiazepine hypnotics)....
Source: Human Psychopharmacology: Clinical and Experimental - January 1, 2016 Category: Psychiatry Authors: Gosia Lipinska, David S. Baldwin, Kevin G. F. Thomas Tags: Short Communication Source Type: research
Sinus Node Dysfunction After Acute Lithium Treatment at Therapeutic Levels
Conclusion
Our case strongly suggests that sinus node dysfunction of lithium can occur even with lithium levels in the therapeutic range and in short-term “acute” treatment. Therefore, patients receiving lithium therapy should have their pulse monitored regulatory for any rhythm abnormalities, and lithium should be discontinued if rhythm disturbances occur during treatment. Further, when prescribing lithium, clinicians should regularly monitor their patients’ ECG and serum lithium levels to prevent serious or fatal complications.
Acknowledgment
The authors would like to thank our colleagues throughout Kosekai-Kusatsu...
Source: Innovations in Clinical Neuroscience - December 1, 2015 Category: Neuroscience Authors: ICN Online Editor Tags: Case Report Current Issue Psychiatry Psychopharmacology Schizophrenia cardiac toxicity ECG Lithium sinus node dysfunction therapeutic level Source Type: research
Patient Background Factors Affecting the Therapeutic Outcomes in Response to Eszopiclone in Adult Patients with Chronic Insomnia: A Post Hoc Analysis of a Double-Blind Phase III Study in Japan
Conclusions:These findings may help clinicians to predict their patients' outcomes in response to standard doses of eszopiclone in clinical practice.Citation:Inoue Y, Kamijo A, Nagai R. Patient background factors affecting the therapeutic outcomes in response to eszopiclone in adult patients with chronic insomnia: a post hoc analysis of a double-blind phase III study in Japan. J Clin Sleep Med 2015;11(10):1171–1178. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - October 16, 2015 Category: Sleep Medicine Source Type: research
Effects of opioid, hypnotic and sedating medications on sleep-disordered breathing in adults with obstructive sleep apnoea.
CONCLUSIONS: The findings of this review show that currently no evidence suggests that the pharmacological compounds assessed have a deleterious effect on the severity of OSA as measured by change in AHI or ODI. Significant clinical and statistical decreases in minimum overnight SpO2 were observed with remifentanil, zolpidem 20 mg and triazolam 0.25 mg. Eszopiclone 3 mg and sodium oxybate 4.5 g showed a beneficial effect on the severity of OSA with a reduction in AHI and may merit further assessment as a potential therapeutic option for a subgroup of patients with OSA. Only one trial assessed the effect of an opioid (remif...
Source: Cochrane Database of Systematic Reviews - July 14, 2015 Category: Journals (General) Authors: Mason M, Cates CJ, Smith I Tags: Cochrane Database Syst Rev Source Type: research
Treatment of chronic insomnia disorder in menopause: evaluation of literature
Conclusions: Although a variety of interventions are shown to be helpful in improving sleep in menopause, there is a need for well-designed head-to-head trials with uniform outcome measures. (Source: Menopause)
Source: Menopause - May 29, 2015 Category: OBGYN Tags: Review Article Source Type: research
Methodological Approaches to Evaluate the Impact of FDA Drug Safety Communications
Conclusions
Using an integrated, multidisciplinary approach, we can obtain information that can be used to optimize regulatory communications by seeking to understand the impact of the information contained in FDA risk communications. (Source: Drug Safety)
Source: Drug Safety - May 12, 2015 Category: Drugs & Pharmacology Source Type: research
Zolpidem and eszopiclone prime α1β2γ2 GABAA receptors for longer duration of activity
Conclusions and ImplicationsAs the derived mechanism successfully simulated the effects of eszopiclone and zolpidem on ensemble currents, we propose it as the definitive mechanism accounting for the effects of both drugs. Importantly, eszopiclone and zolpidem enhanced GABAA receptor currents via a mechanism that differs from that proposed for benzodiazepines. (Source: British Journal of Pharmacology)
Source: British Journal of Pharmacology - May 11, 2015 Category: Drugs & Pharmacology Authors: Christine L Dixon, Neil L Harrison, Joseph W Lynch, Angelo Keramidas Tags: RESEARCH PAPER Source Type: research
Zolpidem and Eszopiclone prime α1β2γ2 GABAA receptors for longer duration activity
CONCLUSIONS AND IMPLICATIONSAs the derived mechanism successfully simulated the effects of eszopiclone and zolpidem on ensemble currents, we propose it as a definitive mechanism accounting for the effects of both drugs. Our findings reveal that eszopiclone and zolpidem enhance GABAAR currents via a mechanism that differs from that proposed for benzodiazepines. (Source: British Journal of Pharmacology)
Source: British Journal of Pharmacology - March 27, 2015 Category: Drugs & Pharmacology Authors: Christine Dixon, Neil L Harrison, Joseph W Lynch, Angelo Keramidas Tags: Research Paper Source Type: research
A rest-activity biomarker to predict response to SSRIs in major depressive disorder
Publication date: Available online 6 March 2015 Source:Journal of Psychiatric Research Author(s): W. Vaughn McCallorcid Most adults with Major Depressive Disorder (MDD) will not experience a remission with the first antidepressant trial. No practical biomarkers presently exist to predict responsiveness to antidepressants. Herein we report pilot data for a rest-activity biomarker of antidepressant response. Fifty-eight medication-free adults with MDD underwent a week-long collection of actigraphic data before beginning a 9 week open label trial of fluoxetine, coupled with blinded randomized assignment to eszopiclone/pl...
Source: Journal of Psychiatric Research - March 7, 2015 Category: Psychiatry Source Type: research
