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Related Concept Videos

Management of Insomnia01:19

Management of Insomnia

The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Insomnia01:27

Insomnia

Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...

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Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia
04:34

Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia

Published on: February 17, 2023

Insomnia pharmacotherapy.

Timothy Roehrs1, Thomas Roth

  • 1Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI 48202, USA. troehrs1@hfhs.org

Neurotherapeutics : the Journal of the American Society for Experimental Neurotherapeutics
|September 15, 2012
PubMed
Summary
This summary is machine-generated.

Approved hypnotics like benzodiazepine receptor agonists (BzRAs), melatonin agonists, and histamine antagonists effectively improve sleep without tolerance. Emerging data suggest these medications also enhance daytime function, offering physicians tailored therapeutic options.

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Area of Science:

  • Pharmacology
  • Sleep Medicine

Background:

  • Several classes of drugs, including benzodiazepine receptor agonists (BzRAs), melatonin receptor agonists, and histamine antagonists, are FDA-approved for treating insomnia.
  • These approved hypnotics exhibit diverse pharmacokinetic profiles, receptor subtype affinities, and formulations, enabling personalized patient treatment.

Purpose of the Study:

  • To review the efficacy, safety, and therapeutic options provided by FDA-approved hypnotics.
  • To discuss the implications of pharmacokinetic differences and formulation variations among these agents.

Main Methods:

  • Review of pharmacokinetic properties of approved hypnotic medications.
  • Analysis of clinical trial data on long-term efficacy and tolerance.
  • Evaluation of side effect profiles and potential drug interactions.

Main Results:

  • FDA-approved hypnotics demonstrate sustained sleep improvement without evidence of tolerance during long-term use.
  • These medications may also positively impact daytime functioning.
  • Side effects are primarily linked to direct sedation, excessive dosing, or co-administration with other sedating substances.

Conclusions:

  • Approved hypnotics offer physicians a range of choices for individualized insomnia therapy.
  • Long-term use of these agents is associated with sustained efficacy and minimal tolerance.
  • Off-label use of anxiolytic BzRAs, antidepressants, and antipsychotics as hypnotics is not recommended due to insufficient data on efficacy and safety.