Science News & Science Current Events
 
Email a Friend Send to a friend
Printer Friendly Print Effects of new sleep medication appear unlikely to have potential for abuse or cognitive impairment

Effects of new sleep medication appear unlikely to have potential for abuse or cognitive impairment

October 03, 2006

In a study of 14 adults with histories of sedative abuse, the newly approved sleep medication ramelteon does not appear to have effects that indicate potential for abuse or motor or cognitive impairment, according to a report in the October issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

About 10 to 15 percent of adults regularly experience chronic insomnia, difficulty sleeping that causes distress or impaired daytime functioning, according to background information in the article. Some of the medications most commonly used to treat the condition (known as benzodiazepine receptor agonists) have a number of problematic side effects. These include a risk for abuse, especially by those with histories of substance abuse; difficulties with cognition (thinking, learning and memory), including a type of amnesia that blocks the formation of new memories; and motor impairments that may make driving dangerous and contribute to falls among older adults. In addition, those who use benzodiazepine receptor agonists long-term may experience withdrawal symptoms-including anxiety, irritability and even seizures-if they stop taking the drugs. Ramelteon, a drug recently approved for treatment of insomnia, works through a different pathway in the brain involving melatonin receptors and therefore may be less likely to cause such effects.




Matthew W. Johnson, Ph.D., and colleagues at The Johns Hopkins School of Medicine, Baltimore, evaluated the potential for abuse and cognitive effects of ramelteon compared with placebo and with triazolam, a benzodiazepine, among 14 adults with histories of abusing sedatives. During approximately 18 days, participants stayed at a residential research unit and received one of the following doses of drugs each day in random order: 16, 80 or 160 milligrams of ramelteon (the recommended treatment dosage is 8 milligrams); .25, .5 or .75 milligrams of triazolam; and placebo. The patients, including one woman and 13 men with an average age of 28, were assessed thirty minutes before taking each drug and repeatedly for the next 24 hours. They answered questions about how much they liked each drug, how strong the drug was and how alert or sleepy they felt, and also underwent cognitive and motor function tests. Trained research staff members also rated the participants' behavior, including how sedated and impaired they seemed and how much they slept.

None of the three doses of ramelteon showed any differences from placebo in effects reported by the participants, measured by performance tests or recorded by research observers. "In contrast, triazolam showed dose-related effects on a wide range of subject-rated, observer-rated and motor and cognitive performance measures, consistent with its profile as a sedative drug with abuse liability," the authors write. When asked the next day about the drug they had taken the day before, 11 of the 14 participants (79 percent) classified the highest dose of ramelteon as a placebo, compared with two (14 percent) who categorized the highest dose of triazolam as placebo and 12 (86 percent) who classified placebo as placebo.

The findings, along with previous clinical trials indicating ramelteon's effectiveness, suggest that it "may fill an unmet need in the treatment of insomnia," the authors write. "Although further clinical trials are warranted, ramelteon may be particularly useful for the treatment of insomnia in individuals with histories of substance abuse, in older subjects (who are especially susceptible to the impairing effects of benzodiazepine receptor agonists), and in persons requiring minimal interference with arousal response (e.g., on-call workers and patients with chronic obstructive pulmonary disease). Furthermore, ramelteon may be a safe first-line medication even in individuals not reporting substance abuse, given that some individuals may not admit to such misuse." Future research on sleep medications should explore the effectiveness of other drugs that work on the same pathway as ramelteon, they conclude.

JAMA and Archives Journals



Related Sleep Medication Current Events and Sleep Medication News Articles
Insomnia: changing your bedtime habits could help
Many people sleep better when they are on holiday and wish that they could sleep as well all the time. But according to the German Institute for Quality and Efficiency in Health Care (IQWiG), it is not only being free of daily worries that can make a difference to sleep.

AASM statement on use of sleep medications
Insomnia occurs when people have trouble falling asleep or staying asleep, and it is a common sleep compliant. While a brief case of insomnia can arise due to temporary stress, excitement or other emotion, more than 20 million Americans report having a chronic form of insomnia that keeps them from sleeping well nearly every night.

Cognitive behavioral therapy appears more effective than sleep medication for treating insomnia
Patients with insomnia who implemented cognitive behavioral therapy interventions such as relaxation techniques had greater improvement in their sleep than patients who received the sleep medication zopiclone.
More Sleep Medication Current Events and Sleep Medication News Articles


Safe Medicine For Sober People: How to Avoid Relapsing on Pain, Sleep, Cold, or Any Other Medication
by Jeffrey Weisberg, Gene Hawes

Safe Medicine for Sober People is a guide for the millions of people in recovery from addiction---and their medical providers---on which medicines are safe to take, from a sober viewpoint, and which are risky. Very specific medications are singled out according to their potential for triggering...



Get a Good Night's Sleep: How to Conquer Your Insomnia Without Drugs or Medication
by Katherine A. Albert

One of the world's leading experts on sleep disorders provides a collection of proven safe and sensible solutions for insomnia and other sleep-related problems that literally keep millions up at...

Don't let nocturia keep you up at night: if your sleep is frequently interrupted by the urgent need to urinate, medication and behavioral changes may help.(URINARY ... HEALTH): An article from: Healthy Years
by Gale Reference Team

This digital document is an article from Healthy Years, published by Thomson Gale on October 1, 2007. The length of the article is 787 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.Citation DetailsTitle: Don't let...

Modafinil shows limits in non-sleep deprived.(Neuropsychiatric Medicine): An article from: Clinical Psychiatry News
by Nicholas Mulcahy

This digital document is an article from Clinical Psychiatry News, published by International Medical News Group on September 1, 2004. The length of the article is 429 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web...



Herbs for a Good Night's Sleep: Herbal Approaches to Relieving Insomnia Safely and Effectively (Keats Good Herb Guide Series)
by David Hoffmann

Medications for attention disorders (ADHD/ADD) and related medical problems (Tourette's syndrome, sleep apnea, seizure disorders): A comprehensive handbook
by Edna D Copeland

Indiplon improves sleep quality without next-day sedation.(Rx): An article from: Internal Medicine News

This digital document is an article from Internal Medicine News, published by International Medical News Group on July 15, 2004. The length of the article is 699 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.Citation...

Atomoxetine doesn't appear to affect sleep onset: children and adolescents with ADHD.(Behavioral Pediatrics)(attention-deficit hyperactivity disorder): An article from: Pediatric News
by Damian McNamara

This digital document is an article from Pediatric News, published by International Medical News Group on December 1, 2003. The length of the article is 458 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.Citation...

Long-Term Zaleplon Appears Safe, Effective for Sleep Disorder.: An article from: Family Practice News
by Carl Sherman

This digital document is an article from Family Practice News, published by International Medical News Group on November 15, 1999. The length of the article is 361 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web...

The medicines for insomnia.(Primer for Prescription Medications): An article from: Annals of the American Psychotherapy Association
by Alan D. Schmetzer

This digital document is an article from Annals of the American Psychotherapy Association, published by American Psychotherapy Association on June 22, 2004. The length of the article is 1260 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it...

© 2008 BrightSurf.com