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Benzodiazepine for insomnia

Morin CM, Belanger L, Bastien C, Vallieres A (2005) Long-term outcome after discontinuation of benzodiazepines for insomnia a survival analysis of relapse. Behav Res Ther 43 1-14... [Pg.21]

Benzodiazepines and other anxiolytics. Although benzodiazepines are widely used in the treatment of acute alcohol withdrawal, most nonmedical personnel involved in the treatment of alcoholism are opposed to the use of medications that can induce any variety of dependence to treat the anxiety, depression, and sleep disturbances that can persist for months following withdrawal. Researchers have debated the pros and cons of the use of benzodiazepines for the management of anxiety or insomnia in alcoholic patients and other substance abuse patients during the postwithdrawal period (Ciraulo and Nace 2000 Posternak and Mueller 2001). [Pg.36]

A rebound sleep disturbance has been found after only 7—10 days of treatment with therapeutic doses of triazolam (Greenblatt et al. 1987). Others have described a withdrawal syndrome after substitution of a short-acting benzodiazepine for a long-acting benzodiazepine (Conell and Berhn 1983). Rebound insomnia may occur with zolpidem. [Pg.129]

Valerian root, an over-the-counter herbal supplement, has also been used for insomnia. Thought to act, like the benzodiazepines, by increasing the activity of the neurotransmitter GABA, preliminary studies indicate that 400 mg of valerian root decreases sleep latency and enhances sleep quality. [Pg.272]

The sedative-hypnotic action of chloral hydrate should be explained by the formation of trichloroethanol, which is synthesized as a result of its reduction in tissues. Despite the fact that the precise mechanism of action of chloral hydrate is not known, it evidently acts analogous to ethanol on the CNS by inCTeasing membrane permeability, which leads to sedation or sleep. Chloral hydrate can be used for insomnia as an alternative to benzodiazepines. Synonyms for this drug are aquachloral, chloradorm, chloratol, noctec, and others. [Pg.65]

Although benzodiazepines, zolpidem, zaleplon, and eszopiclone are the mainstay of pharmacotherapy for insomnia, other sedating drugs, such as trazodone, diphenhydramine, or chloral hydrate, also may be used. Insomnia should first be addressed diagnostically, and in most cases, nonpharmacological interventions should be attempted before treatment with a hypnotic is instituted. Hypnotic agents should be administered in the lowest effective dose. Medications commonly prescribed for insomnia, along with their recom-... [Pg.85]

The newer sedative-hypnotics that are not benzodiazepines are rapidly becoming the first-line treatment for insomnia. These agents not only have pharmacodynamic advantages over benzodiazepines in terms of their mechanism of action, but perhaps more importantly, pharmacokinetic advantages as well. Three nonbenzodiazepine sedative-hypnotic agents that are now available are zaleplon (a pyrazolopyrimidine), zopiclone (a cyclopyrrolone not available in the United States), and zolpidem (an imidazopyridine) (Figs. 8—28-8—30 Table 8—4). [Pg.326]

The benzodiazepines are still widely prescribed for the treatment of insomnia. These agents have been extensively discussed above in terms of their mechanism of action and use in anxiety. Their mechanism of action in insomnia is the same as for anxiety (see Figs. 8—23 to 8—25). Whether a benzodiazepine is used for sedation or for anxiety is based largely on half-life, with the shorter half-life drugs preferred for insomnia because they are more likely to wear off by morning. However, in practice virtually all the benzodiazepines are used for the treatment of insomnia (Table 8-4). [Pg.329]

Longer-term difficulties associated with benzodiazepine use for insomnia come from observations that many patients develop tolerance for these agents, so that they stop working after a week or two. To avoid this, patients must take a sleeping pill only a few times within several days, or for only about 10 days in a row followed by several days or weeks with no drug treatment. Furthermore, if patients persist in taking benzodiazepines as sedative-hypnotics for several weeks to months, there can be a withdrawal syndrome once the medications are stopped, particularly if they are stopped suddenly. This is discussed in further detail in Chapter 13. [Pg.331]

The nonbenzodiazepine sedative-hypnotics zaleplon, zolpidem, and zopiclone are replacing benzodiazepine sedative-hypnotics as first-line treatments for insomnia. Some antidepressants, such as sedating tricyclic antidepressants and trazodone, are also used as sedative-hypnotic agents for the treatment of insomnia. [Pg.334]

To review the drug treatments for insomnia, including newer nonbenzodiazepine hypnotics as well as benzodiazepine and other hypnotics. [Pg.622]

As well as compounds specifically indicated for the short-term treatment of insomnia, some benzodiazepines used primarily as anxiolytics have found extensive usage as symptomatic remedies for insomnia in anxious individuals. Examples include oxazepam, lorazepam, and diazepam. Patterns of use vary from country to country and at different times. [Pg.253]

It should be noted that all these alternative treatments for insomnia also have side effects, some of which (e.g. TCAs) are potentially more serious than those occurring with the benzodiazepine group. [Pg.251]

Barbiturates are still used as sedative/hypnotic agents (see Chapter 3), but they have been largely replaced by benzodiazepines for treatment of anxiety and insomnia (difficulty sleeping). Barbiturates are still used occasionally, but benzodiazepines have proven to be much safer and have less risk of accidental overdose. [Pg.41]

Diazepam is better indicated if insomnia is associated with daytime anxiety. Other benzodiazepines prescribed for insomnia include nitrazepam, flur-azepam, loprazolam, lormetazepam and temazepam. The non-benzodiazepine hypnotics zaleplon, zolpidem and zopiclone are not licensed for long-term use. The sedative antipsychotic promethazine hydrochloride is sometimes used to facilitate sleep, with a 25-50 mg recommended dose. Melatonin has proved effective for some clients, mostly in regulating the sleep/waking cycle. Although evidence of efficacy is limited, some clients use herbs such as valerian and chamomile. If Mr AB will finally be diagnosed with depression, a trial with an antidepressant will be indicated. [Pg.91]

Nitrazepam is a long-acting benzodiazepine used primarily for insomnia. However, it has a long half-life (about 24 hours) and poses a substantial risk of residual daytime effects, including sedation, psychomotor and cognitive impairment, and accidental injury (1). [Pg.426]


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See also in sourсe #XX -- [ Pg.55 ]




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