Common Insomnia Drugs Receive Black Box Warning
A black box warning about the risk of serious injury and potential death as a result of sleepwalking and other complex sleep behaviors has been added to the labeling of the sedative–hypnotic drugs zolpidem, zaleplon, and eszopiclone.Serious adverse effects from use of these drugs to treat insomnia include falls with serious injuries, fatal falls, fatal motor vehicle accidents, self-injury, and suicidal attempts and suicides, among others.NPs should not prescribe these drugs to patients who have a history of complex sleep behaviors after taking antiinsomnia drugs. The drugs should be discontinued if patients experience ad...
Source: AJN - July 30, 2019 Category: Nursing Tags: Drug Watch Source Type: research
Bitterness-Masking Effects of Different Beverages on Zopiclone and Eszopiclone Tablets.
This study therefore showed that the bitterness intensities of zopiclone and eszopiclone can be suppressed by citric-acid-contained beverages and suggests that this bitterness suppression is due to a direct electrostatic interaction between citric acid and the two drugs.
PMID: 31061364 [PubMed - in process] (Source: Chemical and Pharmaceutical Bulletin)
Source: Chemical and Pharmaceutical Bulletin - May 9, 2019 Category: Drugs & Pharmacology Authors: Yoshida M, Kojima H, Uda A, Haraguchi T, Ozeki M, Kawasaki I, Yamamoto K, Yano I, Hirai M, Uchida T Tags: Chem Pharm Bull (Tokyo) Source Type: research
FDA Requires Stronger Warnings for Common Insomnia Medications
On Tuesday, the Food and Drug Administration (FDA) announced that several prescription sleep aids must now include aboxed warning—the FDA’s strongest safety warning—following reports of sleepwalking and other rare sleep behaviors that have led to serious injuries and deaths.Sleep aids containing eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien, Ambien CR, Edluar, Intermezzo, and Zolpimist) must carry the boxed warning as well as another warning against the use of the medications by patients with a history of sleepwalking or other rare sleep behaviors like sleep driving.This is not the first time that th...
Source: Psychiatr News - April 30, 2019 Category: Psychiatry Tags: Ambien Ambien CR and Zolpimist boxed warning Edluar eszopiclone FDA insomnia Intermezzo lunesta sleepwalking Sonata zaleplon zolpidem Source Type: research
Indirect synchronous fluorescence spectroscopy and direct high-performance thin-layer chromatographic methods for enantioseperation of zopiclone and determination of chiral-switching eszopiclone: Evaluation of thermodynamic quantities of chromatographic separation.
Abstract
Economic and enantioselective synchronous fluorescence spectroscopy and high-performance thin-layer chromatography methods have been developed and validated as per ICH guidelines for the separation of zopiclone enantiomers using L-(+)-tartaric acid as a chiral selector, followed by determination of the chiral-switching eszopiclone. Synchronous fluorescence spectroscopy was successfully applied for chiral recognition of R & S enantiomers of zopiclone at ∆λ = 110 nm based on creating of diastereomeric complexes with 0.06M tartaric acid in an aqueous medium containing 0.2M disodium hydrogen...
Source: Chirality - March 11, 2019 Category: Molecular Biology Authors: Moussa BA, Youssef NF, Elkady EF, Mohamed MF Tags: Chirality Source Type: research
Patient Education and Pharmacist Consultation Influence on Nonbenzodiazepine Sedative Medication Deprescribing Success for Older Adults.
CONCLUSION: Patients who received direct-to-patient education with or without a pharmacist consultation were significantly more likely to discontinue Z-drug use than patients receiving UC. Providing evidence-based information about Z-drug use is an effective and low-resource method to encourage drug discontinuation.
PMID: 30624198 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - January 10, 2019 Category: General Medicine Tags: Perm J Source Type: research
The effect of nonbenzodiazepines sedative hypnotics on apnea & #8211;hypopnea index: A meta-analysis
CONCLUSIONS: The majority of patients using NBSH did not develop any worsening of existing AHI, when using NBSH, regardless of their baseline AHI values (mild, moderate, severe, or no OSA). On average, the AHI improved minimally with NBSH and eszopiclone showed the largest difference in AHI with an MD of −5.73 events/h. (Source: Annals of Thoracic Medicine)
Source: Annals of Thoracic Medicine - January 10, 2019 Category: Respiratory Medicine Authors: Gaurav Nigam Macario Camacho Muhammad Riaz Source Type: research
Eszopiclone for insomnia.
CONCLUSIONS: Eszopiclone appears to be an efficient drug with moderate effects on sleep onset and maintenance. There was no or little evidence of harm if taken as recommended. However, as certain patient subgroups were underrepresented in RCTs included in the review, findings might not have displayed the entire spectrum of possible adverse events. Further, increased caution is required in elderly individuals with cognitive and motor impairments and individuals who are at increased risk of using eszopiclone in a non-recommended way.
PMID: 30303519 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 10, 2018 Category: General Medicine Authors: Rösner S, Englbrecht C, Wehrle R, Hajak G, Soyka M Tags: Cochrane Database Syst Rev Source Type: research
Cognitive behavioral therapy for insomnia combined with eszopiclone for the treatment of sleep disorder patients transferred out of the intensive care unit: A single-centred retrospective observational study
Patients transferred out of the intensive care unit (ICU) are always impaired by sleep disorders. Cognitive behavioral therapy for insomnia (CBT-I) and eszopiclone are 2 commonly prescribed strategies for insomnia. In the current study, the effect of the combined application of the 2 methods on sleep disorders in ICU transferred out patients was assessed.
Twenty-nine insomnia patients receiving combined treatment of CBT-I and eszopiclone and a corresponding number of patients treated with eszopiclone were collected. The incidence of discomfort experiences in ICU was recorded. Polysomnogram (PSG), Pittsburgh Sleep Quality ...
Source: Medicine - September 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Insomnia in Elderly Patients: Recommendations for Pharmacological Management
AbstractChronic insomnia affects 57% of the elderly in the United States, with impairment of quality of life, function, and health. Chronic insomnia burdens society with billions of dollars in direct and indirect costs of care. The main modalities in the treatment of insomnia in the elderly are psychological/behavioral therapies, pharmacological treatment, or a combination of both. Various specialty societies view psychological/behavioral therapies as the initial treatment intervention. Pharmacotherapy plays an adjunctive role when insomnia symptoms persist or when patients are unable to pursue cognitive behavioral therapi...
Source: Drugs and Aging - September 1, 2018 Category: Geriatrics Source Type: research
Treatment Options for Insomnia in Schizophrenia: A Systematic Review
Conclusions Despite a very limited number of specific studies on this matter, all 4 studies have shown good benefit/risk ratios and reviewed options—melatonin, paliperidone, and eszopiclone—might represent valid options for residual insomnia in schizophrenia. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Pharmacopsychiatry)
Source: Pharmacopsychiatry - July 30, 2018 Category: Psychiatry Authors: Oliveira, Pedro Coroa, Manuel Madeira, Nuno Tags: Review Source Type: research
Zolpidem and Eszopiclone Pre-medication for PSG: Effects on Staging, Titration, and Adherence.
Conclusions: In a population with predominantly mild obstructive sleep apnea, NBSHs did not improve PSG or CPAP titration quality and did not increase CPAP adherence. There was no difference in effect between eszopiclone and zolpidem.
PMID: 29961838 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - July 4, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Sedative Hypnotics and the Risk of Falls and Fractures in the Elderly.
Authors: Andrade C
Abstract
Older age, poor sleep, and the use of the "Z" sedative hypnotic drugs (zopiclone, eszopiclone, zolpidem, and zaleplon) commonly go together. Each of these can increase the risk of falls and fractures through mechanisms related to cognitive and psychomotor impairment. A recent systematic review and meta-analysis examined the risk of falls and fractures associated with the use of the Z-drugs. The authors of that meta-analysis identified 14 relevant cohort and case-control studies. They found that Z-drugs increased the risk of falls in 2 out of 3 studies that provided information o...
Source: Journal of Clinical Psychiatry - June 8, 2018 Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
Long-Term Use of Hypnotics Up Significantly From 1999 to 2014, Study Finds
Long-term use of benzodiazepine (BZD) and non-benzodiazepine hypnotics (NBH) appears to have grown significantly during a 15-year period between 1999 and 2014, independent of demographic shifts, according to areport today inPsychiatric Services in Advance.Because clinical guidelines suggest that both types of medications should be used on a short-term basis, the findings highlight “the pressing need for better delineation of appropriate medium- and long-term use of these medications,” wrote lead author Christopher Kaufmann, Ph.D., M.H.S., of the University of California, San Diego, and colleagues.The researchers analyz...
Source: Psychiatr News - November 1, 2017 Category: Psychiatry Tags: benzodiazepines hypnotics long-term use non-benzodiazepine hypnotics sleep problems Source Type: research
Z-drugs and risk for falls and fractures in older adults —a systematic review and meta-analysis
Conclusionour results indicate that Z-drugs are associated with an increased risk for fractures, and suggest a possible increased risk for falls and injuries as well. However, studies included were observational and susceptible to confounding. Physicians should consider these potential risks before prescribing these medications in older adults. (Source: Age and Ageing)
Source: Age and Ageing - October 25, 2017 Category: Geriatrics Source Type: research
