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Benzodiazepine hypnotics remain effective for 24 weeks.
British Medical Journal (Clinical Research Ed.)
|March 20, 1982
Summary
Benzodiazepines like lormetazepam and nitrazepam effectively improve sleep for up to 24 weeks. However, sleep disturbances are expected after discontinuing these medications, with impairments peaking days after withdrawal.
Area of Science:
- Pharmacology
- Sleep Medicine
- Clinical Psychology
Background:
- Benzodiazepines are commonly prescribed hypnotics for insomnia.
- Long-term efficacy and withdrawal effects of benzodiazepines require further investigation.
Purpose of the Study:
- To evaluate the sustained effectiveness of benzodiazepine hypnotics (lormetazepam and nitrazepam) over 24 weeks.
- To assess the sleep quality and latency following withdrawal of these medications.
Main Methods:
- A 32-week study involving 97 poor sleepers (aged 40-68 years).
- Participants received nightly capsules of lormetazepam (2 mg) or nitrazepam (5 mg), or placebo.
- Daily subjective sleep ratings were collected throughout the study.
Main Results:
- Both lormetazepam and nitrazepam demonstrated sustained sleep improvement compared to placebo after 24 weeks.
- Lormetazepam significantly shortened sleep latency.
- Sleep latency and quality worsened significantly below baseline after drug withdrawal, with maximal impairment observed 2-4 days post-withdrawal.
Conclusions:
- Benzodiazepines maintain effectiveness for insomnia for at least 24 weeks.
- A period of disturbed sleep is a predictable consequence of benzodiazepine withdrawal.