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Related Concept Videos

Management of Insomnia01:19

Management of Insomnia

244
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...
244
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

171
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...
171
Insomnia01:27

Insomnia

85
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...
85
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

358
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...
358
CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

259
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...
259
Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

243
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...
243

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Related Experiment Video

Updated: Jun 29, 2025

Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia
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[Pharmacotherapies for insomnia].

Marie-Françoise Vecchierini1, Damien Léger2

  • 1Centre du sommeil et de la vigilance, Hôtel-Dieu, AP-HP, Paris, FranceM.-F. Vecchierini déclare avoir participé à des essais et des conférences pour Bioprojet et ResMed, et avoir été prise en charge, à l'occasion de déplacements pour congrès, par SOS Oxygène, Linde, Bioprojet et ResMed. D. Léger déclare avoir participé à des interventions ponctuelles pour Idorsia, BioSerenity, Vanda Pharmaceuticals, iSommeil, Sanofi, et avoir été pris en charge, à l'occasion de déplacements pour congrès, par Linde, SOS Oxygène et VitalAire.

La Revue Du Praticien
|March 29, 2024
PubMed
Summary

Cognitive behavioral therapy is the first line for chronic insomnia, but medications like Z-drugs and melatonin are also used. Orexin antagonists represent a new class of insomnia pharmacotherapies.

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Area of Science:

  • Pharmacology
  • Sleep Medicine
  • Neuroscience

Context:

  • Cognitive Behavioral Therapy (CBT) is the primary treatment for chronic insomnia but faces accessibility challenges.
  • Pharmacological interventions are frequently prescribed due to CBT's limitations.
  • Existing insomnia medications include Z-drugs, antihistamines, and off-label antidepressants.

Purpose:

  • To review current pharmacotherapies for adult chronic insomnia.
  • To compare the efficacy and safety profiles of various insomnia medications.
  • To introduce new therapeutic options like melatonin and orexin antagonists.

Summary:

  • Z-drugs (zolpidem, zopiclone) aid sleep initiation with fewer side effects than benzodiazepines but have a 28-day prescription limit.
  • Antihistamines have limited efficacy and risks of next-day sedation, especially in the elderly.
  • Slow-release melatonin is approved for insomnia in individuals over 55, offering sleep improvement without withdrawal or abuse potential.
  • Orexin antagonists, such as daridorexant, are a novel class of hypnotics, with their role in chronic insomnia management still under investigation.

Impact:

  • Provides a comparative overview of insomnia pharmacotherapies, aiding clinical decision-making.
  • Highlights the benefits and limitations of current treatments, including safety considerations.
  • Introduces emerging pharmacotherapies, such as melatonin and orexin antagonists, for insomnia management.