Zaleplon Diphenhydramine

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-... 

A 14-year-old boy with major depressive disorder responded to paroxetine 20 mg/day with full remission of depressive symptoms except insomnia (16). Diphenhydramine and trazodone did not improve his sleep and caused excessive daytime drowsiness. He then responded well to zaleplon 10 mg, but when he took two extra tablets 3 weeks later he developed complex behavior and sleepwalking. He had slurred speech, was slow in responding to questions, was moderately confused, and was uncoordinated and moved slowly. Physical examination, routine laboratory investigations, and an electrocardiogram were all normal. He remained in hospital for 8 hours and awakened without any memory of his activities. His mental state at 1 week and 1 month were both normal. 

Benzodiazepines impair psiychomotor performance, but neither ebasitine nor mizolastine (both non-sedating antihistamines) further impair this. An enhanced sedative effect would be expected if known sedative antihistamines are given with benzodiazepines. Diphenhydramine did not alter the pharmacokinetics of zaleplon. 

A randomised single dose three-period erossover study in healthy subjeets found that diphenhydramine 50 mg had no significant effect on the phar-macokineties of a single 10-mg dose of zaleplon, despite the fact diphenhydramine is a moderate inhibitor of the primary metabolic pathway [aldehyde oxidase] of zaleplon. ... 

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See also in sourсe #XX -- [ ]

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